Clover Health

Senior Strategic Configuration Analyst

Remote - USA · Senior

Sponsorship not specified$107k-$130kDetected 20 days ago

LLMsCommunicationCollaborationMentoring

About the role

As a Medicare Advantage plan, we aim to empower our members by helping them navigate the complexities of healthcare and live healthier lives.
Your focus is the technical validation and rigorous testing of configuration logic.
Your health matters to us, and we invest in ensuring you have access to quality healthcare. - Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance.

Collaborate with the Senior Manager to provide detailed "failed-test" analysis and comprehensive impact assessments, documenting the financial and operational risk where configuration logic diverged from intended outcomes.
Manage the technical validation lifecycle across testing and UAT environments to ensure "zero-defect" deployments into the live production environment.
Maintain detailed records of test results, training materials, and configuration procedures to ensure transparency and compliance with CMS regulations.

You possess strong hands-on experience with HealthEdge HRP and Source.
You are incredibly detail-oriented and have a knack for identifying "edge cases"-those rare but high-dollar scenarios that standard testing might miss.
You have a deep understanding of the end-to-end claim lifecycle and how provider contracts and clinical edits should be technically operationalized in a claims system.
You have strong verbal and written communication skills with the ability to translate complex technical findings for diverse stakeholders.

Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
Reimbursement for office setup expenses
Monthly cell phone & internet stipend
Paid parental leave for all new parents
About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier.
We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.
Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one's identity.
Develop and execute complex, scenario-based testing models that simulate real-world medical encounters to ensure configuration holds up under various coding conditions and modifier applications.

We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives.

This listing is sourced directly from Clover Health's careers page and normalized into a canonical job model.