Healthcare Product Configuration Analyst

We are seeking a Healthcare Product Configuration Analyst with strong technical and analytical skills to support the configuration, implementation, and maintenance of healthcare products, benefit plans, and system rules. The ideal candidate will have hands-on experience with healthcare payer systems, product configuration, SQL, and Excel VBA/Macros.

This role requires collaboration with business, operations, and technology teams to configure healthcare products, analyze data, validate system changes, and support production implementations.

Required Qualifications

• 3+ years of experience in Healthcare Product Configuration, Benefits Administration, Claims Processing, Enrollment Systems, or Healthcare Operations.
• Strong SQL proficiency including complex queries, joins, data validation, and reporting.
• Advanced Microsoft Excel skills including VBA Macros, automation, pivot tables, and advanced formulas.
• Experience configuring healthcare products, benefit plans, provider networks, eligibility rules, or claims adjudication rules.
• Knowledge of healthcare payer operations, health plans, claims, enrollment, eligibility, and provider management.
• Experience performing data analysis, troubleshooting, and system testing.
• Strong analytical, problem-solving, and communication skills.

Preferred Qualifications

• Experience with Commercial, Medicare, Medicaid, or ACA health plans.
• Experience working with healthcare payer platforms or claims administration systems.
• Knowledge of healthcare data standards including HIPAA transactions.
• Experience with Agile/Scrum environments.
• Exposure to reporting and visualization tools such as Power BI or Tableau.

Key Responsibilities

• Configure and maintain healthcare products, benefit plans, eligibility rules, provider networks, and claims processing rules.
• Analyze business requirements and translate them into system configurations.
• Develop and maintain Excel VBA Macros and automated reporting solutions.
• Write SQL queries to analyze healthcare data, validate configurations, and troubleshoot production issues.
• Support testing activities including System Integration Testing (SIT), User Acceptance Testing (UAT), and production validation.
• Collaborate with Product Owners, Business Analysts, Operations, and IT teams to implement product enhancements.
• Investigate configuration-related issues and recommend solutions.
• Create and maintain configuration documentation, business rules, and test cases.
• Participate in product implementations, upgrades, and regulatory compliance initiatives.
• Ensure accuracy and consistency of healthcare product configurations across systems.

Technical Skills

• SQL (Advanced)
• Microsoft Excel (Advanced)
• VBA/Macros
• Healthcare Product Configuration
• Benefits Configuration
• Claims & Eligibility Systems
• Data Analysis & Reporting
• UAT / SIT Testing
• Business Requirements Analysis