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SCAN

Not-for-profit Medicare Advantage plan for seniors

Configuration Program Lead - Contracts

Enterprise ApplicationsConfirmed live in the last 24 hours
Full-time$92.4k - $133.7k /yr

About the Job

Requirements

  • A bachelor's degree or equivalent experience is required.
  • Five years of experience in healthcare payer operations, health plan configuration, provider contract administration, network operations, claims administration, or a related field is required.
  • Ability to interpret and translate complex contract, provider network, and operational requirements into accurate system configuration and business rules.
  • Strong knowledge of configuration implementation, testing, validation, and change-management practices to ensure configuration accuracy and compliance.
  • Ability to collaborate with cross-functional stakeholders, including Network Management, Provider Operations, Claims, Legal, Compliance, IT, and business partners, to resolve issues and achieve operational objectives.
  • Strong analytical and problem-solving skills, including the ability to identify configuration risks, dependencies, process improvement opportunities, and automation solutions.
  • Advanced Microsoft Office Suite, SQL, and Visio skills are required.

Responsibilities

  • Lead configuration activities associated with DOFR, NCN, and other contract-related requirements.
  • Interpret approved contract terms and operational requirements and translate them into accurate system configuration.
  • Coordinate implementation, validation, testing, and issue resolution associated with new or modified contract configuration.
  • Partner with Network Management, Provider Operations, Claims, Legal, Compliance, IT, and other business partners to resolve configuration questions and discrepancies.
  • Maintain governance, documentation, controls, and change-management processes for contract configuration.
  • Identify configuration risks, dependencies, and opportunities for process improvement, standardization, and automation.
  • Actively support the achievement of SCAN’s Vision and Goals.
  • Perform other duties as assigned.

Desired Qualifications

  • Experience translating contractual and operational requirements into system configuration, coordinating testing and implementation activities, and partnering with cross-functional stakeholders to support accurate and compliant configuration processes is preferred.

About the Company

SCAN

Not-for-profit Medicare Advantage plan for seniors

SCAN provides health coverage for seniors through Medicare Advantage and offers community programs like Independence at Home and Volunteer Action for Aging. Members enroll in SCAN’s Medicare Advantage plan to receive medical benefits, and SCAN also runs in-home care and community services that support aging in place, funded by the organization and partners. It differentiates itself as a not-for-profit with a long history (since 1977) focused on seniors and caregivers and backed by strong employee benefits and community engagement. The goal is to help seniors stay healthy and independent by improving access to care and strengthening the communities the organization serves.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Long Beach, CA
Founded
1977

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