Configuration Analyst

Position Description:

The HRP Configuration Analyst is responsible for the end-to-end configuration maintenance and testing of benefit and claims processing rules within the Health Rules Payor (HRP) platform by HealthEdge. This role serves as the technical bridge between clinical/product operations and system configuration ensuring accurate benefit adjudication compliant claims payment and high-quality testing outcomes across all lines of business.

This role must be performed near any CGI office - Hybrid

Your future duties and responsibilities:

Benefit configuration
. Configure and maintain benefit plans cost-sharing structures accumulators and coverage rules in Health Rules Payor (HRP)
. Translate benefit plan documents (SBCs EOBs product grids) into accurate HRP system configuration
. Set up and manage benefit periods deductibles out-of-pocket maximums copays coinsurance and exclusion/limitation logic
. Configure coordination of benefits (COB) subrogation rules and Medicare/Medicaid crossover logic as applicable
. Support annual benefit year rollover plan refresh and mid-year plan amendments
Claims testing & validation
. Design and execute end-to-end claim test scripts (professional institutional dental pharmacy) to validate configuration accuracy
. Perform regression UAT and production validation testing for new configurations and system upgrades
. Identify document and track defects; partner with IT and HealthEdge support for resolution
. Validate claim adjudication outcomes against expected benefit logic including repricing edits and remittance advice
. Maintain test case libraries and testing documentation in support of audit and compliance requirements
Cross-functional collaboration
. Partner with product clinical operations finance and compliance teams to gather configuration requirements and confirm business intent
. Serve as a subject matter expert on HRP functionality during product launches regulatory changes and system enhancements
. Participate in HealthEdge upgrade planning release management and production cutover activities
. Support provider network loading fee schedule configuration and code table maintenance as needed
Quality governance & documentation
. Maintain thorough configuration change documentation version control and audit trail records
. Develop and follow configuration standards SOPs and naming conventions across the HRP environment
. Support internal and external audits related to claims payment accuracy and benefit administration compliance
. Monitor post-production claim runs for configuration anomalies and escalate issues appropriately

Required qualifications to be successful in this role:

.3-5 years of hands-on HRP (HealthEdge Health Rules Payor) configuration experience
.Strong working knowledge of medical claim adjudication logic and benefit plan structures
.Experience with ICD-10 CPT HCPCS and revenue code sets
.Proficiency in claim testing methodology (unit regression UAT)
.Familiarity with HIPAA 837/835 transaction standards
.Strong analytical skills with attention to configuration detail and accuracy
.Ability to translate complex benefit documents into system configuration requirements

Other Information:
CGI is required by law in some jurisdictions to include a reasonable estimate of the compensation range for this role. The determination of this range includes various factors not limited to skill set level experience relevant training and licensure and certifications. To support the ability to reward for merit-based performance CGI typically does not hire individuals at or near the top of the range for their role. Compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range for this role in the U.S. is $80600.00 - $172400.00.

CGIs benefits are offered to eligible professionals on their first day of employment to include:
. Competitive compensation
. Comprehensive insurance options
. Matching contributions through the 401(k) plan and the share purchase plan
. Paid time off for vacation holidays and sick time
. Paid parental leave
. Learning opportunities and tuition assistance
. Wellness and Well-being programs

#LI-MP2

Skills:

• Benefits Management
• Business Process Mapping
• Health Care Analytics
• Health Care Payers
• Oracle
• SQL

What you can expect from us:

Together as owners lets turn meaningful insights into action.

Life at CGI is rooted in ownership teamwork respect and belonging. Here youll reach your full potential because

You are invited to be an owner from day 1 as we work together to bring our Dream to life. Thats why we call ourselves CGI Partners rather than employees. We benefit from our collective success and actively shape our companys strategy and direction.

Your work creates value. Youll develop innovative solutions and build relationships with teammates and clients while accessing global capabilities to scale your ideas embrace new opportunities and benefit from expansive industry and technology expertise.

Youll shape your career by joining a company built to grow and last. Youll be supported by leaders who care about your health and well-being and provide you with opportunities to deepen your skills and broaden your horizons.

Come join our teamone of the largest IT and business consulting services firms in the world.

Qualified applicants will receive consideration for employment without regard to their race ethnicity ancestry color sex religion creed age national origin citizenship status disability pregnancy medical condition military and veteran status marital status sexual orientation or perceived sexual orientation gender gender identity and gender expression familial status or responsibilities reproductive health decisions political affiliation genetic information height weight or any other legally protected status or characteristics to the extent required by applicable federal state and/or local laws where we do business.

CGI provides reasonable accommodations to qualified individuals with disabilities. If you need an accommodation to apply for a job in the U.S. please email the CGI U.S. Employment Compliance mailbox at . You will need to reference the Position ID of the position in which you are interested. Your message will be routed to the appropriate recruiter who will assist you. Please note this email address is only to be used for those individuals who need an accommodation to apply for a job. Emails for any other reason or those that do not include a Position ID will not be returned.

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All CGI offers of employment in the U.S. are contingent upon the ability to successfully complete a background investigation. Background investigation components can vary dependent upon specific assignment and/or level of US government security clearance held. Dependent upon role and/or federal government security clearance requirements and in accordance with applicable laws some background investigations may include a credit check. CGI will consider for employment qualified applicants with arrests and conviction records in accordance with all local regulations and ordinances.

CGI will not discharge or in any other manner discriminate against employees or applicants because they have inquired about discussed or disclosed their own pay or the pay of another employee or applicant. However employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information unless the disclosure is (a) in response to a formal complaint or charge (b) in furtherance of an investigation proceeding hearing or action including an investigation conducted by the employer or (c) consistent with CGIs legal duty to furnish information.