Health Plan Configuration Manager

đź•’ vor 1 Monat

🇺🇸 Vereinigte Staaten – Remote

đź’µ $98.000 - $130.000 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

đźź  Senior

đź‘” Manager

đź‘» Geisterscore 11%

infoinfo

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Gravie

Gravie

201 - 500 Mitarbeiter

GegrĂĽndet 2013

🏥 Gesundheitswesen

🛡️ Versicherung

🤝 B2B

💰 €150.000.000 Private Equity Round - Gravie im 2025-05

Healthcare • Insurance • B2B

Gravie ist ein Unternehmen für Gesundheitsleistungen und Versicherungslösungen, das kleinen und mittelständischen Arbeitgebern, Maklern und Arbeitnehmern hilft, flexiblere und kostengünstigere Gesundheitsleistungen zu erhalten und zu verwalten. Zu den Hauptangeboten gehören Comfort (ein fondsfinanzierter Gesundheitsplan), Gravie ICHRA (Verwaltung der individuellen Health Reimbursement Arrangement), Gravie Pay (Unterstützung bei Gesundheitskosten) und Gravie Care. Das Unternehmen konzentriert sich darauf, kleinen und mittelständischen Unternehmen zu ermöglichen, individualisierte und kostengünstigere Abdeckungen anzubieten und die Verwaltung von Leistungen zu vereinfachen.

Beschreibung

• 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

🎯 Anforderungen

• 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

🏖️ Vorteile

• 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

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