Configuration Manager

About the Role

The main functions of this position are responsible for leading, coaching, and guiding staff that implement, support, and maintain the core administrative system configuration including but not limited to: EDI transactions, provider, health plan benefits and member eligibility data, encounters submissions and reconciliations, CMS/health plan claim reporting, internal claim reporting, and data entry. This role will continue to enhance the vision, value proposition, and services for the configuration function and develop and align the staff to deliver against these services.

Responsibilities

• Coordinate and supervise daily/weekly/monthly activities of team members, including setting priorities to ensure task completion and performance goals are met.
• Respond to configuration escalations.
• Provide coaching, feedback, annual performance reviews, and formal corrective action.
• Manage inventory and performance to business metrics.
• Write and submit Policy & Procedure (P&P) update requests.
• Provide expertise or general system configuration support to the team in reviewing, researching, and investigating system configuration.
• Support team employee engagement.
• Communicate and collaborate with internal and external business partners.
• Document and communicate the status of system configuration to stakeholders as needed.
• Achieve applicable performance metrics (productivity, quality, turnaround time, utilization).
• Use advanced problem-solving, critical thinking, and process analysis skills to lead teams responsible for client configuration.
• Demonstrate leadership in configuration activity or function, with knowledge of configuration best practices, methodologies, and tools.
• Perform other tasks assigned by the manager.

Requirements

• Strong understanding of local, state, and federal rules regarding the adjudication of medical benefits.
• Strong organizational and time management skills with the ability to prioritize individual workloads.
• Proficient in MS Office with strong computer skills (e.g., multiple systems experiences, keyboarding skills, Microsoft Word, PowerPoint).
• Strong knowledge of CPT, HCPCS, ICD-10, DRG, and APC coding and CMS Guidelines.
• Ability to drive performance management.
• Ability to interpret electronic data interchange preferred.
• Knowledge of CMS EDI file and submission protocols.
• Knowledge of CMS claim reporting: ODAG and Part C.
• 6+ years of healthcare administration operational experience.
• 5 years of healthcare operations and healthcare system configuration knowledge.
• Experience managing at least six direct reports.
• Extensive experience in plan building, provider data maintenance, and reimbursement methodologies including fee schedules, contract management, and workflow processes.
• Experience analyzing and identifying trends preferred.

Qualifications

• High school diploma or GED required.
• Bachelor’s degree preferred.

Skills

• Understanding of the healthcare industry, including competitors, the regulatory environment, and industry trends.
• Ability to provide strategic leadership and demonstrate the ability to develop future-state scenarios, create a vision for the future, define factors needed to achieve success, and key actions required.
• Demonstrated leadership skills.

Pay

Pay range: $100,000–135,000 depending on experience.

Schedule

This role offers a hybrid work arrangement, working in-office three days per week.

About the Company

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives, and engage patients. We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of healthcare, transforming it from sickness care into wellness guidance. If you are passionate about your work, eager to have fun, and motivated to be part of a fast-growing organization, then you should consider joining our team.