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Medicare Operations Configuration Analyst Jobs (NOW HIRING)

DKMRBH Inc.

Configuration Mgmt Analyst

Albany, NY · On-site

W2 Configuration Management / Release Management / DevOps Tools We are looking for a Configuration Management Analyst / Configuration Analyst with strong experience in software configuration ...

Avera Health

Configuration Analyst

Sioux Falls, SD · On-site

$63K - $96K/yr

As a Configuration Analyst you will work closely with clinical, operational, and technical stakeholders to translate complex business needs into efficient system solutions, while maintaining the ...

Avera Health

Configuration Analyst

Sioux Falls, SD

$63K - $96K/yr

As a Configuration Analyst you will work closely with clinical, operational, and technical stakeholders to translate complex business needs into efficient system solutions, while maintaining the ...

Tegria Company

This role collaborates with business stakeholders, operations teams, and IT partners to translate ... Experience with Medicare, Medicaid, Commercial, or Exchange products.* Knowledge of EDI ...

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Medicare Operations Configuration Analyst information

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How much do medicare operations configuration analyst jobs pay per hour?

As of Sep 15, 2026, the average hourly pay for medicare operations configuration analyst in the United States is $41.31, according to ZipRecruiter salary data. Most workers in this role earn between $30.53 and $52.88 per hour, depending on experience, location, and employer.

What does a Medicare Operations Configuration Analyst do?

A Medicare Operations Configuration Analyst is responsible for setting up and maintaining the rules and parameters within healthcare systems that ensure Medicare plans are administered correctly. They analyze regulatory requirements, configure benefits and provider data, and troubleshoot issues related to claims processing and plan configuration. This role often involves collaborating with IT, compliance, and operations teams to make sure Medicare policies are accurately reflected in system configurations. Their work is essential for ensuring members receive the correct benefits and that the organization remains compliant with federal regulations.

What are the key skills and qualifications needed to thrive as a Medicare Operations Configuration Analyst?

To thrive as a Medicare Operations Configuration Analyst, you need a solid understanding of Medicare regulations, healthcare operations, and claims processing, often supported by a degree in healthcare administration or a related field. Familiarity with healthcare configuration systems (such as Facets or QNXT), claims adjudication tools, and sometimes relevant certifications like CPC are typically required. Strong analytical thinking, attention to detail, and effective communication skills help distinguish top performers in this role. These competencies ensure accurate benefit configuration, regulatory compliance, and smooth operational workflows in Medicare programs.

What are some common challenges faced by Medicare Operations Configuration Analysts when implementing benefit changes?

Medicare Operations Configuration Analysts often encounter challenges when translating complex regulatory requirements and benefit updates into system configurations. Staying current with frequently changing CMS guidelines and ensuring accuracy in configuration to avoid errors in claims processing can be demanding. Additionally, collaboration with cross-functional teams such as compliance, IT, and claims operations is essential to resolve discrepancies and ensure smooth implementation. Attention to detail and strong communication skills are crucial to navigate these challenges and maintain compliance.

What are popular job titles related to Medicare Operations Configuration Analyst jobs?

For Medicare Operations Configuration Analyst jobs, the most frequently searched job titles are:

Configuration Analyst

Tampa, FL • On-site

Avalon Administrative Services LLC
See more jobs at Avalon Administrative Services LLCexternal

Full-time

Re-posted 14 hours ago

Job description

About Avalon Healthcare Solutions:

Avalon Healthcare Solutions is the nation’s leader in diagnostic intelligence, uniquely focused on transforming the role of diagnostic testing across the healthcare ecosystem. Our proprietary Diagnostic Insights Platform delivers evidence-based policies, curated lab networks, and real-time analytics that simplify complex diagnostics, accelerate innovation adoption, and optimize diagnostic investments.

Supporting over 30 health plans and 100 million members nationwide, Avalon partners with payers and providers to ensure diagnostic testing is performed appropriately, efficiently, and at the right time. Our flexible solutions span routine and genetic testing management, automated adherence, and end-to-end diagnostics support—driving measurable value, reduced waste, and improved clinical outcomes.

With unmatched scientific rigor, deep clinical expertise, and a performance-based model, Avalon is redefining how diagnostics power personalized care and healthcare value.
 Learn more at www.avalonhcs.com.

You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com.

Avalon Healthcare Solutions is an Equal Opportunity Employer - Vet/Disability. 

This position description is subject to change at any time. As determined by the company based upon business needs, an employee in this position may be required to perform duties and take responsibility for work other than as described in this document.

About the Configuration Analyst Position:

Reporting to the Manager, Configuration, the Configuration Analyst is responsible for updating managed care claims processing, maintenance and support of interfaces and third-party applications, process flow updates and enhancements.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Configuration Analyst – Essential Functions and Responsibilities:

  • Perform analyses of Avalon laboratory benefits management configuration in order to determine and create use cases for regression testing. 
  • Ability to take requirements from medical policy translation documents and successfully incorporate these as rules in the Avalon laboratory benefits management configuration file.
  • Run regression testing prior to Production releases for Avalon Claim Editor to ensure optimal functionality of the Claim Editor.
  • Development and maintenance of ReadyAPI! test suite for regression testing management. 
  • Validate and/or provide input to LBM global rules process flows.

Configuration Analyst – Minimum Qualifications:

  • 3+ years of relevant work experience
  • Bachelor’s degree in Business or similar field or equivalent work experience
  • At least 3 years of experience developing and managing business requirements throughout a project lifecycle.
  • Experience in or knowledge of the health care business and customer service.
  • Intermediate knowledge of Microsoft Excel and Access.
  • Experience with use case testing.
  • 1 - 2 years’ experience in reporting, with a preference for intermediate knowledge of SQL 
  • Knowledge of one or more of the following areas of health plan operations - configuration, utilization, claims processing, and/or reimbursement.
  • Proven analytical and project management skills, including a thorough understanding of how to interpret customer business needs and translate them into application and operational requirements.
  • Facilitation skills that include workgroup leadership, problem resolution across multiple groups, etc.
  • Willingness to work in various capacities and to learn new skill sets.

Apply