Configuration Analyst

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 $80,600.00 - $172,400.00.

CGI's 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

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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.

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