Manager, Configuration Center of Excellence

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Medica's Manager, Configuration Center of Excellence (COE), leads a team of Business Analysts and Quality Auditors that support configuration delivery across the organization. The COE provides audit oversight, claims impact analysis, process improvement, requirements management, training, documentation, reporting, and operational support to configuration teams. This role is responsible for establishing and advancing the COE's strategy, governance framework, operating standards, and best practices. The Manager partners closely with Configuration Delivery, Configuration Architecture, Product Design, Information Technology, Claims, Internal Audit, Operations Training and Readiness, and other business stakeholders to improve configuration quality, reduce operational risk, increase visibility, and support scalable delivery processes. Initially, this leader will focus on clarifying responsibilities across the Business Analyst and Quality Auditor functions, improving work assignment and visibility, and preparing the COE to support additional configuration teams. The role will also identify opportunities to strengthen quality controls, improve operational efficiency, and expand the value delivered by the COE. Performs other duties as assigned. Key Accountabilities Configuration Quality, Auditing, and Governance (25%) Establish and maintain configuration quality standards, audit frameworks, and governance processesOversee production, operational, service, and ad hoc configuration auditsDevelop audit methodologies, quality controls, documentation standards, and reporting processesMonitor completed configuration work to identify errors, trends, risks, and opportunities for improvementCommunicate audit findings and recommendations to Configuration Delivery leadershipPartner with Business Analysts and operational teams to address recurring process issuesSupport corporate audit activities, including regulatory, compliance, and internal audit reviewsMaintain centralized audit documentation, findings, and historical reportingEnsure adherence to configuration standards, internal controls, and regulatory requirements Operational Excellence, Process Improvement, and Claims Impact Support (25%) Lead continuous improvement initiatives across business configuration operationsOversee claims impact reporting related to retroactive configuration changesPartner with Claims and Configuration Delivery teams to support claims reprocessing effortsAnalyze root causes of retroactive changes, including configuration errors, requirements gaps, and operational delaysRecommend process improvements, training opportunities, and enhanced controls based on findingsImprove work intake, prioritization, assignment, tracking, and visibility processesCollaborate with business and technology teams to identify automation opportunitiesEstablish operational standards that support consistency, efficiency, and scalabilityMeasure and communicate business outcomes and operational improvements Training, Onboarding, and Knowledge Management (15%) Oversee development and maintenance of training materials, job aids, standard operating procedures, process flows, and configuration documentationCoordinate training programs with configuration leadership, subject matter experts, and learning partnersIdentify training needs based on audit results, operational trends, and business requirementsSupport onboarding, cross-training, and ongoing employee development initiativesEnsure training and process documentation remains current and accurateFoster knowledge sharing and best practice adoption across configuration teams Project Support, Requirements Management, and Strategic Initiatives (15%) Lead Business Analyst support for configuration and enterprise-wide initiativesEstablish standards and best practices for business requirements gathering and documentationPartner with stakeholders to define requirements and translate business needs into actionable solutionsSupport implementation planning and transition activities from project delivery to operationsAdvise stakeholders on configuration impacts, risks, dependencies, and implementation considerationsPromote governance, documentation, and stakeholder alignment throughout project lifecyclesExpand COE support capabilities across benefits, claims, provider, health services, and other configuration functions Leadership, Reporting, and Team Development (20%) Lead, coach, and develop a team of Business Analysts and Quality AuditorsDefine roles, responsibilities, and workload distribution across the COEEstablish team goals, priorities, and performance expectations aligned with organizational objectivesFoster a collaborative and inclusive environment that supports employee engagement and professional growthDevelop and monitor quality metrics, operational KPIs, dashboards, and reportingPresent findings, trends, risks, and recommendations to leadershipBuild strong partnerships across Configuration, Claims, Operations, Technology, Compliance, and Audit functionsIdentify emerging business needs and drive initiatives that improve configuration delivery effectivenessDevelop roadmaps and strategic plans that support the continued growth and maturity of the COE Required Qualifications Bachelor's degree in Business Administration, Management Information Systems, Information Technology, Healthcare Administration, or a related field, or equivalent combination of education and experience5+ years of experience in healthcare operations, business configuration, business analysis, quality assurance, process improvement, or a related area2+ years of people leadership experience Preferred Qualifications Experience working within the HealthRules Payor ecosystemExperience leading operational improvement initiatives or developing new business functionsExperience supporting healthcare payer operations and cross-functional business teamsExperience leading teams responsible for reporting, analysis, auditing, project support, or process improvementHands-on healthcare configuration experienceExperience supporting benefits, claims, provider, or health services configuration functionsExperience with GuidingCare or other healthcare administration platformsExperience establishing, expanding, or leading a Center of ExcellenceExperience leading automation, process optimization, or operational maturity initiativesLean Six Sigma Green Belt (or higher)Project Management Professional (PMP) certificationCertified Business Analysis Professional (CBAP) certificationQuality Management or Operational Excellence certification Skills And Abilities Knowledge of healthcare payer operations, claims processing, benefits configuration, provider reimbursement, and related business functionsUnderstanding of configuration delivery processes and the operational impact of configuration changesExperience developing governance frameworks, standards, and operational processesExperience with business analysis, requirements management, and project facilitationAbility to analyze audit findings, operational data, trends, and risksExperience developing and managing performance metrics, reporting, and dashboardsKnowledge of quality assurance, compliance, audit, and risk management practicesStrong analytical, problem-solving, organizational, and prioritization skillsAbility to communicate complex concepts and findings to technical and non-technical audiencesStrong written, verbal, presentation, and stakeholder management skillsAbility to influence decisions and build alignment across departments and leadership levelsDemonstrated leadership, coaching, employee development, and change management capabilities This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI. The full salary grade for this position is $100,300 - $172,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $100,300 - $150,465. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Internal Applicants: We’re excited about your interest in growing your career at Medica! To be eligible to apply for internal opportunities, employees must have been in their current role for at least one year. Recruiter: Brandon Dehn Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.