Senior Strategic Configuration Analyst (Healthcare)

TL;DR

Senior Strategic Configuration Analyst (Healthcare): Technical validation and testing of configuration logic for Medicare Advantage claims payment accuracy with an accent on HealthEdge HRP/Source and technical quality assurance. Focus on designing scenario-based testing models, performing root cause analysis of payment variances, and integrating LLMs to optimize test case generation.

Location: Remote (Must be based in the USA)

Salary: $107,000 - $130,000 USD

Company

hirify.global is reinventing health insurance by combining data with human empathy to keep members healthier through custom software and analytics.

What you will do

• Architect and execute comprehensive test plans for member benefits, provider contracts, and coding edits including LCD, NCD, and NCCI.
• Develop complex, scenario-based testing models to simulate real-world medical encounters.
• Perform detailed defect impact analysis and document financial and operational risks where logic diverged from outcomes.
• Manage the technical validation lifecycle across testing and UAT environments to ensure zero-defect deployments.
• Simulate payment variances in test environments to confirm root causes and validate configuration fixes.
• Utilize LLMs such as Claude, Gemini, and ChatGPT to create test scenarios and identify edge cases.

Requirements

• 5+ years of experience in Medicare Advantage or healthcare plan configuration, testing, or technical QA.
• Strong hands-on experience with HealthEdge HRP and Source.
• Deep understanding of the end-to-end claim lifecycle and the technical operationalization of provider contracts.
• Proven ability to identify high-dollar edge cases in complex reimbursement logic.
• Strong verbal and written communication skills for translating technical findings to stakeholders.
• Must be based in the USA.

Culture & Benefits

• Competitive base salary, equity opportunities, performance-based bonuses, and 401k matching.
• Comprehensive medical, dental, and vision coverage for employees and families.
• Remote-first culture with monthly cell phone/internet stipends and office setup reimbursement.
• Mental health support, No-Meeting Fridays, and a generous flexible time-off policy.
• Professional development funding, mentorship, and regular performance feedback.
• Employee Stock Purchase Plan (ESPP) and paid parental leave.