What are the responsibilities and job description for the Manager, Configuration position at HMSA?
Employment Type
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
Note: Individuals typically begin between the minimum to middle of the pay range
The Manager, Configuration is responsible for the strategic management, governance, and oversight of configuration processes across the health plan's core administrative systems. This role ensures that all benefit plans, provider contracts, fee schedules, payment rules, and enrollment structures are configured accurately, timely, and in compliance with regulatory and contractual requirements. The manager collaborates with internal and external partners to establish best practices to systematically drive accuracy, efficiency, and member/provider satisfaction.
Minimum Qualifications
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
- Hybrid Work Environment - Must reside in Hawaii**
Note: Individuals typically begin between the minimum to middle of the pay range
The Manager, Configuration is responsible for the strategic management, governance, and oversight of configuration processes across the health plan's core administrative systems. This role ensures that all benefit plans, provider contracts, fee schedules, payment rules, and enrollment structures are configured accurately, timely, and in compliance with regulatory and contractual requirements. The manager collaborates with internal and external partners to establish best practices to systematically drive accuracy, efficiency, and member/provider satisfaction.
Minimum 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.
- 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.
Salary : $78,000 - $153,000