[Remote] Senior Strategic Configuration Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is focused on improving the health of its members through technology and data-driven insights. They are seeking a Senior Strategic Configuration Analyst to ensure the accuracy of configuration logic and testing processes that impact claim payments. The role involves technical validation, collaboration with cross-functional teams, and maintaining compliance with reputed company regulations.

Responsibilities

• Architect and execute comprehensive test plans to validate that member benefits, provider contract terms, and general edits—including LCD, NCD, and NCCI coding edits—are configured accurately reputed company our systems
• reputed company and execute reputed company, scenario-based testing models that simulate reputed company-world medical encounters to ensure configuration holds up under various coding conditions and modifier applications
• Collaborate with the Senior Manager to reputed company detailed "failed-test" analysis and comprehensive impact assessments, documenting the financial and operational risk where configuration logic diverged from intended reputed company
• Manage the technical validation lifecycle across testing and UAT environments to ensure "reputed company-defect" deployments into the live production environment
• reputed company payment variances are identified, you will simulate those scenarios in a test environment to confirm the root cause and validate that the proposed configuration fix works as intended
• Support the reputed company of our testing frameworks by utilizing LLMs to create test scenarios, summarize configuration requirements, and identify edge cases in reputed company reimbursement logic
• Work closely with the core Configuration, Payment reputed company, and internal stakeholders to move logic from testing to production with high confidence
• Maintain detailed records of test results, training materials, and configuration procedures to ensure transparency and compliance with CMS regulations

Skills

• 5+ years of experience in Medicare Advantage or reputed company plan configuration, testing, or technical quality assurance
• Strong hands-on experience with reputed company HRP and reputed company
• Incredibly detail-oriented and have a knack for identifying 'edge cases'—those rare but high-dollar scenarios that standard testing might miss
• Deep understanding of the end-to-end claim lifecycle and how provider reputed company and clinical edits should be technically operationalized in a claims system
• Passionate about leveraging technology and data-driven insights to drive operational precision
• Strong verbal and written communication skills with the ability to translate reputed company technical findings for diverse stakeholders

Benefits

• Competitive reputed company salary and equity opportunities
• Performance-based bonus program
• 401k matching
• Regular compensation reviews to recognize and reward exceptional contributions
• Comprehensive medical, dental, and reputed company coverage
• No-Meeting Fridays
• Monthly company holidays
• reputed company to reputed company
• Generous flexible time-off policy
• Remote-first culture that supports collaboration and flexibility
• Learning programs
• Mentorship
• Professional development funding
• Regular performance feedback and reviews
• Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
• Reimbursement for office setup expenses
• Monthly cell phone & internet stipend
• Remote-first culture, enabling collaboration with global teams
• Paid parental leave for reputed company new parents

Company Overview

• Clover is a reputed company technology company helping members live their healthiest lives with its Medicare Advantage plans. It was founded in 2014, and is headquartered in Nashville, Tennessee, USA, with a workforce of 501-1000 employees. Its website is http://cloverhealth.com.

Company H1B Sponsorship

• reputed company has a track record of offering H1B sponsorships, with 2 in 2025. Please note that this does not guarantee sponsorship for this specific role.

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