Health Plan Configuration Manager

🕒 Agosto 21

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $98.000 - $130.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Gravie

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 2013

🏥 Saúde

🛡️ Seguros

🤝 B2B

💰 $150.000.000 Private Equity Round - Gravie em 2025-05

Healthcare • Insurance • B2B

A Gravie é uma empresa de soluções de benefícios e seguros de saúde que ajuda pequenas e médias empresas, corretores e funcionários a acessar e administrar benefícios de saúde mais flexíveis e acessíveis. Seus principais produtos incluem Comfort (um plano de saúde com financiamento em nível definido), Gravie ICHRA (administração de Arranjo de Reembolso de Saúde para Cobertura Individual), Gravie Pay (suporte para custos de saúde) e Gravie Care. A empresa se concentra em capacitar PMEs a oferecer cobertura individualizada e de menor custo, além de simplificar a administração de benefícios.

Descrição

• Execute the configuration strategy and roadmap, translating vision into actionable priorities • Lead, develop, and scale a team of configuration and EDI analysts, including hiring, mentoring, performance management, and succession planning • Partner with Product, Engineering, Operations, Finance, and leadership to align configuration capacity and priorities • Manage configuration-related vendor relationships, SLAs, performance, and escalations • Develop and maintain taxonomies for benefit categories, networks, plans, and configuration structures • Oversee technical support for claim loading, EDI transactions (837, 835, 278), and system troubleshooting • Own EDI trading partner and clearinghouse relationships and resolve transaction errors • Support the automation roadmap and deploy efficiency and quality improvements • Establish policies, controls, QA standards, documentation, and audit compliance practices • Manage staffing and resource planning for the configuration function • Provide leadership visibility into KPIs, risk, capacity, and performance trends • Lead cross-functional coordination during open enrollment, Q4, and system upgrades • Serve as a senior subject matter expert on Gravie's claims system and configuration operations • Act as the primary escalation point for complex configuration and EDI issues

🎯 Requisitos

• 6+ years of claims system subject matter expertise • 3+ years leading teams, team leads, or managers in a configuration, claims operations, or healthcare IT function • Ability to operate as a strategic partner to senior leadership and translate ambiguous direction into clear plans • Proven ability to influence senior and executive stakeholders and drive organizational or process change at scale • Strong executive presence, communication, and cross-functional relationship-building skills • Experience owning budgets, vendor contracts, or SLAs and making resource trade-off decisions • Ability to guide teams through complex technical and configuration problems • Ability to deal with ambiguity and take decisive action • Strong organizational, time management, and prioritization skills • Working knowledge of EDI transaction standards (837, 835, 834, 278) and their integration with claims configuration and adjudication • Experience in a regulated healthcare or health plan environment is extra credit • Experience supporting system integrations or large-scale platform migrations is extra credit • Previous startup or high-growth company experience is extra credit • Experience managing EDI clearinghouse relationships or trading partner onboarding is extra credit • Must be currently authorized to work in the United States

🏖️ Benefícios

• Alternative medicine coverage • Flexible PTO • Up to 16 weeks paid parental leave • Paid holidays • 401k program • Transportation perks • Education reimbursement • 2 days of paid paw-ternity leave • Standard health and wellness benefits