Clinical Care Configuration Analyst (Remote work)

Remote Position: Clinical Care Configuration Analyst

Location: Any location within the US
Duration: FTE / Permanent
Salary: $72,000 – $89,000

Summary

The ideal candidate will perform analysis, design, and maintenance of the Clinical Care Advance system and other assigned platforms. You will serve as a subject matter expert, identifying and resolving configuration issues, recommending improvements, and ensuring high-quality deliverables. This role involves providing recommendations for vendor system enhancements, testing delivered features, and integrating them into ongoing configuration strategies.

Required Skills, Experience & Education

• Education: Bachelor's degree in business or a healthcare-related field (equivalent education/experience considered).
• Experience:
  • Minimum 5 years in Systems Configuration, Claims, or Operations within a healthcare organization.
  • 2 to 5 years of experience with clinical and care management systems (e.g., CareAdvance Enterprise Application).
  • Working knowledge of enterprise systems such as Facets.
• Knowledge:
  • Advanced knowledge of health plan configuration (healthcare services, medical management, population health management).
  • Familiarity with industry care guidelines (e.g., Milliman Care Guidelines).
  • Understanding of configuration change management methodologies and best practices.
• Project Management: Ability to manage projects independently from end to end.
• Analytical Skills: Ability to analyze processes, document workflows, perform gap analysis, and develop future-state standardized workflows.

Daily Responsibilities

• Gather requirements, perform analysis, and develop configuration designs to meet business needs.
• Manage complex system configuration and related documentation.
• Serve as a subject matter expert for configuration change management testing and best practices.
• Facilitate production controls and system configuration data codification.
• Monitor system edits and conduct advanced root cause analysis to identify issues and provide resolution recommendations.
• Identify and implement process improvements.
• Collaborate with Healthcare Services and the broader organization to support configuration management life cycle.
• Support project plans and track configuration changes, operational issues, and resolutions.
• Represent the team on internal and external committees.
• Provide system-based recommendations for enhancement requests.
• Lead configuration project timelines to meet deliverables.
• Coordinate the preparation and execution of test plans to validate configuration updates and system fixes.