Manager, Configuration

About the role

The Manager, Configuration oversees the day-to-day operations and tactical execution of benefit configuration across the organization’s core claims platforms. This role ensures accurate and timely implementation of plan designs, fee schedules, and payment methodologies while maintaining compliance with regulatory and audit standards.

Responsibilities

• Provide day-to-day leadership, guidance, and support to Configuration Analysts, fostering a culture of accountability, collaboration, and continuous improvement.
• Oversee workforce planning, hiring, onboarding, and performance management for configuration staff in collaboration with the Director, Configuration.
• Maintain adherence to regulatory and compliance requirements, including SOC controls and HIPAA standards.
• Support audit readiness and assist with internal/external audit activities.
• Implement quality assurance processes, including test plan development and defect prevention for system changes.
• Partner with IT, Operations, and Product teams to assess new business needs and recommend scalable configuration solutions.
• Serve as a subject matter expert for configuration during audits, client meetings, and enterprise initiatives.
• Support integration with third-party vendors and provider networks as needed.
• Identify opportunities for automation, process optimization, and system enhancements to improve efficiency and accuracy.
• Contribute to continuous improvement initiatives and recommend best practices for configuration workflows.
• Support and lead special projects as assigned or necessary.

Requirements

• Bachelor's Degree Required
• Advanced degree preferred
• 5 Years Required Notes: 5+ years of experience in healthcare benefit configuration or claims system administration required
• 3+ years of leadership experience managing teams or projects required
• Advanced knowledge of medical claims adjudication, benefit structures, and provider reimbursement methodologies required
• Familiarity with regulatory requirements (HIPAA, SOC controls) and audit processes required
• Strong working knowledge of Microsoft Office required; familiarity with SQL Server Management Studio (SSMS) and data querying preferred
• Experience with configuration platforms such as Plexis Claims Manager (PCM), HSP Meditrac, or similar systems preferred

Qualifications

• N/A

Skills

• Strong leadership and project management skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office and SQL Server Management Studio (SSMS)
• Knowledge of healthcare benefit structures and provider reimbursement methodologies
• Experience with configuration platforms such as Plexis Claims Manager (PCM), HSP Meditrac, or similar systems

Benefits

• Comprehensive Total Rewards package including health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents
• Opportunities for advancement and development throughout all stages of your career

Pay

The expected salary range for this position is $95,000.00 – $116,000.00 annually, based on role scope, experience, and market considerations.

Schedule

Full-time position