Health Plan Configuration Analyst

Dragonfly Health • Mesa, AZ

1d

About The Position

Essential Functions Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager. 1. Configure, implement, and maintain health plan benefits and related system applications in alignment with product design, contractual obligations, and regulatory requirements. 2. Analyze existing health plans to identify required updates driven by market changes, legislative mandates, compliance requirements, and operational improvements. 3. Translate business and product requirements into system configuration specifications. 4. Support the end-to-end lifecycle of plan changes, including design review, system configuration, testing, validation, and implementation. 5. Execute and document testing activities to ensure system accuracy, benefit integrity, and compliance with state and federal regulations. 6. Partner with Product, Compliance, IT, Claims, and Operations teams to resolve system issues and implement corrective actions. 7. Investigate configuration defects and support remediation efforts to minimize operational disruption and member/provider impact. 8. Ensure adherence to audit controls, documentation standards, and internal governance processes. 9. Contribute to the development and maintenance of standard operating procedures and configuration documentation. 10. Support training initiatives and knowledge transfer within the team. 11. Maintain awareness of evolving regulatory requirements and industry trends impacting health plan administration. Marginal or Additional Functions 1. Performs other duties as assigned or apparent. Supervisory and Managerial Responsibility Supervisory/managerial responsibility is not applicable

Requirements

• Bachelor’s degree in Business, Healthcare Administration, Information Systems, or a related field
• One to two (1-2) years of experience in health plan configuration, plan build, or related systems work
• Strong working knowledge of Microsoft Outlook, Word, PowerPoint, and Excel (including pivot tables, data comparison, and structured analysis)
• Demonstrated attention to detail and ability to manage multiple assignments with accuracy
• Ability to interpret documented procedures, regulatory standards, and business requirements
• Strong analytical and problem-solving skills
• Working knowledge of a PC, business and communications software (MS Office) and web-based tools are required

Nice To Haves

• Experience in health insurance operations, preferably in claims processing, product development, benefits configuration, or customer service preferred
• Experience with benefits administration or claims processing systems preferred
• Working knowledge of Microsoft Access a plus
• Experience supporting audits or compliance reviews preferred
• Familiarity with health plan regulatory requirements (e.g., state mandates, CMS guidelines, ACA requirements) preferred

Responsibilities

• Configure, implement, and maintain health plan benefits and related system applications in alignment with product design, contractual obligations, and regulatory requirements.
• Analyze existing health plans to identify required updates driven by market changes, legislative mandates, compliance requirements, and operational improvements.
• Translate business and product requirements into system configuration specifications.
• Support the end-to-end lifecycle of plan changes, including design review, system configuration, testing, validation, and implementation.
• Execute and document testing activities to ensure system accuracy, benefit integrity, and compliance with state and federal regulations.
• Partner with Product, Compliance, IT, Claims, and Operations teams to resolve system issues and implement corrective actions.
• Investigate configuration defects and support remediation efforts to minimize operational disruption and member/provider impact.
• Ensure adherence to audit controls, documentation standards, and internal governance processes.
• Contribute to the development and maintenance of standard operating procedures and configuration documentation.
• Support training initiatives and knowledge transfer within the team.
• Maintain awareness of evolving regulatory requirements and industry trends impacting health plan administration.
• Performs other duties as assigned or apparent.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level