Plan Configuration & Member Onboarding Analyst

How You Will Contribute Plan Configuration & Administration Own end-to-end plan configuration activities for new and existing members, including new plan builds, amendments, renewals, terminations, network arrangements, pricing requirements, steering and tiering, effective dates, and related operational attributes.

Interpret agreements, implementation documents, benefit requirements, network selections, pricing methodologies, and TPA instructions and translate them into accurate and operationally sound configuration requirements.

Evaluate the downstream impact of plan configuration decisions, including how network, pricing, steering, tiering, eligibility, and effective-date decisions affect claims processing, provider selection, discounts, member responsibility, reporting, and the overall member experience.

Validate information across documents and systems, identify inconsistencies, missing information, or conflicting requirements, and document configuration requirements and key decisions as appropriate.

Resolve or escalate configuration issues that could affect claims payment, discounts, provider reimbursement, member servicing, or operational accuracy.

Member Onboarding & Lifecycle Management Coordinate member onboarding from implementation through operational activation, ensuring required information, documentation, agreements, and system configurations are complete and accurate.

Coordinate member lifecycle activities, including renewals, plan changes, amendments, and terminations.

Partner with Employer Engagement, Business Development, Operations, and downstream servicing teams to support effective implementation and ongoing member administration.

Work with employer members, agents, TPAs, and other external stakeholders to collect, review, and validate required implementation information and obtain clarification or approval when needed.

Manage implementation priorities, deadlines, dependencies, and requirements; provide status updates and identify risks that could affect implementation timelines or outcomes.

Quality Assurance, Testing & Risk Management Maintain quality-control practices through standardized checklists, documented approvals, testing, audit trails, reconciliation, and post-implementation validation.

Develop and execute testing scenarios to validate plan configuration and related operational requirements before changes are released to production.

Compare expected and actual results, investigate defects, coordinate corrections, and obtain required approvals.

Monitor early claims and operational results following implementation to identify inaccurate configuration, lost or misapplied discounts, or other unintended outcomes.

Identify and escalate risks that could affect claims accuracy, provider reimbursement, member experience, financial outcomes, or operational performance.

Data Integrity & Systems Management Maintain accurate, complete, and current member and plan information within The Alliance's CRM, plan configuration, pro...