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, project management, document management, and other operational systems.
• Enter, update, and validate member and plan information and conduct recurring audits and maintenance activities to identify and resolve data discrepancies.
• Research data issues, engage appropriate internal resources, and fulfill data and research requests related to member and plan information.
• Stay informed of business and process changes and partner with the Director of Operations, Technology, and other stakeholders to support system enhancements.

Stakeholder Partnership & Customer Service

• Build effective working relationships with employer members, agents, TPAs, external partners, and internal stakeholders.
• Provide responsive and professional service by communicating clearly, anticipating needs, responding to questions, and following issues through resolution.
• Collaborate across Employer Engagement, Business Development, Claims, Eligibility, Network, Pricing, Product, Technology, Marketing, Finance, Compliance, and other functions to support accurate and timely member servicing.
• Communicate complex plan configuration, network, pricing, claims, and operational concepts effectively to technical and nontechnical audiences.

Problem Solving & Continuous Improvement

• Research configuration, data, claims-processing, and member-servicing issues and perform root-cause analysis to identify appropriate solutions.
• Engage subject-matter experts as needed and coordinate issues through resolution.
• Identify opportunities for continuous improvement by evaluating recurring defects, rework, system limitations, audit findings, and member experience issues.
• Partner with Operations, Technology, and other stakeholders on process improvements, technology implementations, and system changes that improve operational effectiveness and the member experience.

Team & Organizational Support

• Serve as an operational resource regarding plan configuration, member onboarding, networks, pricing, TPAs, claims-processing impacts, and related workflows.
• Support departmental projects and organizational initiatives as assigned.
• Participate in cross-training and knowledge-sharing activities and provide backup support for critical member onboarding and plan configuration activities.
• Maintain current knowledge of relevant industry practices, internal processes, systems, and business requirements.

Your Qualifications

• Five or more years of progressively responsible experience in health insurance, self-funded healthcare, plan administration, claims operations, network operations, pricing, implementation, account management, or a closely related field.
• Demonstrated experience interpreting complex plan, benefit, pricing, network, contract, or administrative requirements.
• Working knowledge of healthcare claims processing and the downstream impact of plan configuration decisions.
• Experience performing detailed work subject to quality controls, testing, audits, reconciliation, or formal approval processes.
• Strong analytical and problem-solving skills with the ability to evaluate information from multiple sources and identify appropriate solutions.
• Strong organizational skills with the ability to manage multiple priorities, deadlines, dependencies, and stakeholders while maintaining accuracy.
• Strong written and verbal communication skills with the ability to communicate complex information clearly to technical and nontechnical audiences.
• Demonstrated attention to detail and commitment to data and configuration accuracy.
• Ability to exercise independent judgment, recognize risk, and appropriately resolve or escalate issues.
• Ability to collaborate effectively across teams and functions.
• Intermediate to advanced proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint.
• Experience using CRM, project management, workflow, or similar business systems.
• Ability to learn and effectively use plan configuration, claims, network, pricing, and other operational systems.
• Ability to adapt to changing business needs, processes, priorities, and technology.

Stand-Out From the Crowd Qualifications

• Experience working within a self-funded healthcare environment.
• Experience with Microsoft Dynamics CRM or a comparable CRM platform.
• Experience with plan configuration, healthcare claims, network administration, pricing, or member implementation.
• Experience with project management or workflow management tools such as ClickUp.
• Project management training, education, or experience coordinating complex implementations.
• Experience supporting system implementations, enhancements, testing, or process-improvement initiatives.

Physical Aspects of the Job

• Regularly required to sit, work at a computer, and communicate via phone, video, and email.
• Occasionally required to stand or walk.
• Visual acuity required for computer-based work and detailed document and data review.
• Occasional travel or schedule flexibility may be required based on business needs.

What to Know about the Job

The Plan Configuration & Member Onboarding Analyst is responsible for plan configuration and member onboarding activities for new and existing members. The role translates member benefit, pricing, network, and administrative requirements into accurate plan configurations that support claims processing and member administration.

The Analyst coordinates member implementations, plan changes, renewals, and terminations and maintains accurate member and plan information across operational systems. The position works collaboratively with Employer Engagement, Business Development, Claims, Network, Pricing, Technology, and external partners to support accurate and timely member implementation and ongoing administration.

Who We Are

At The Alliance, our mission is helping employers self-fund smart. We serve as the voice for self-funded employers who want more control over their healthcare costs and who believe that affordable, high-quality care should be accessible to everyone.

Why Work at The Alliance?

Along with the satisfaction you’ll receive from working with a mission-driven organization, you’ll join a humble, lively, and hard-working group of people. The Alliance is home to a highly collaborative, creative, and dedicated bunch; you’ll feel our warm friendliness, be fueled by our inspiring passion, and find support from us when you need it, too.