What are the responsibilities and job description for the Manager, Configuration position at Hawaii Medical Service Association?
- Provide strategic management and direction for the configuration of health plan products, provider networks, and reimbursement methodologies to ensure alignment with business requirements, state and federal regulations, and accreditation standards.
- Develop and implement policies, standards, and governance frameworks for configuration accuracy, quality control, and compliance.
- Collaborate with external partners, IT, Claims Operations, Provider Services, Compliance, and Product teams to ensure system configurations support new products, regulatory changes, and organizational initiatives.
- Lead testing, validation, and sign-off processes for new configurations, system upgrades, and change requests
- Drive process improvements and automation opportunities to enhance configuration efficiency and reduce errors.
- Serve as a subject matter expert (SME) for configuration management, providing training, guidance, and mentorship to internal and external team members and business stakeholders.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
Qualifications:
- Bachelor's degree and five years of related work experience; or equivalent combination of education and related work experience.
- Five years of management/supervisory experience.
- In-depth knowledge of managed care, PPO, HMO, Medicaid, Medicare Advantage, and commercial group health plans
- Strong working knowledge of claims adjudication systems (e.g., Facets, QNXT, Epic Tapestry, HealthEdge)
- Effective written and verbal communication skills
- Intermediate knowledge of Microsoft Office applications including, but not limited to Word, Powerpoint, Outlook and Excel.