Health Plan Configuration Manager

🕒 il y a 1 mois

🇺🇸 États-Unis – Télétravail

💵 $98 000 - $130 000 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

👻 Score fantôme 11%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Gravie

Site WebLinkedInTous les Emplois

201 - 500 employés

Fondée en 2013

🏥 Santé

🛡️ Assurance

🤝 B2B

💰 €150 000 000 Private Equity Round - Gravie en 2025-05

Healthcare • Insurance • B2B

Gravie est une entreprise spécialisée dans les solutions d'assurance santé et de prestations qui aide les petites et moyennes entreprises, les courtiers et les employés à accéder et à gérer des prestations de santé plus flexibles et abordables. Ses offres phares incluent Comfort (un plan de santé à financement partiel), Gravie ICHRA (gestion des remboursements des frais médicaux pour les couvertures individuelles), Gravie Pay (assistance pour les coûts liés aux soins de santé) et Gravie Care. L'entreprise se concentre sur la capacité des PME à offrir des couvertures individualisées à moindre coût, tout en simplifiant la gestion des prestations.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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