Configuration Coordinator

Medica; Minnetonka (MN); Remote; USD 57,000 - 97,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

PTO

Holidays

Paid volunteer time off

401K contributions

Caregiver services

Job summary

Medica is seeking a Configuration Coordinator to handle the configuration and maintenance of business rules across core systems, including HealthRules, COSMOS, and UNET. This remote role supports reimbursement policies, member/provider contracts, enrollment, and secure access.

The position emphasizes accuracy and timely configuration for new markets and products. Responsibilities include identifying discrepancies in the system that impact claims processing and ensuring high-quality

Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Healthcare Management, Healthcare Informatics, or a related degree; or an equivalent combination of education and related work experience.
• 1+ years of related experience, including configuration knowledge, system workflow, and/or design.

Responsibilities

• Configure and maintain business rules within core system ecosystem (COSMOS, UNET, HealthRules, and others).
• Assist in configuring new markets and products and manage rules for reimbursement policies, contracts, enrollment, and security.
• Identify, research, and resolve inaccuracies affecting claims payment and upstream/downstream processes, focusing on HealthRules Payor configuration.

Skills

Configuration knowledge

System workflow

Design

Education

Bachelor's degree in healthcare administration or related field

Tools

HealthRules

COSMOS

UNET

FACETS

QNXT

Trizetto

IKASystems

Amisys

MetaVance

Job description

Description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We’re a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It’s our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

Responsible for all tasks related to configuration and maintenance of the business rules within core system ecosystem. Performs other duties as assigned.

Role Summary

Medica’s Configuration Coordinator is responsible for all tasks related to configuration and maintenance of business rules within the ecosystem, including COSMOS, UNET, HealthRules, and others. Medica’s Configuration Coordinators play a key role in the configuration and implementation of new markets and products and manage the configuration of business rules that support reimbursement policies and methodologies, member/provider contracts, enrollment, billing, role-based security, and correspondence.

In addition, the Configuration Coordinator identifies, researches, and resolves inaccuracies and inconsistencies in the system as they impact claims payment and other upstream and downstream transactions and processes. This opening will focus primarily on benefits and claims configuration within the HealthRules Payor application.

Required Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Healthcare Management, Healthcare Informatics, or a related degree program; or an equivalent combination of education and related work experience.
• 1+ years of related experience, including configuration knowledge, system workflow, and/or design.

Preferred Qualifications

• Experience implementing and configuring health plan core administration systems (e.g., FACETS, QNXT, Trizetto, MetaVance, HealthRules, IKASystems, Amisys, COSMOS, UNET) strongly preferred.
• Healthcare experience strongly preferred
• Claims processing, claims adjudication, and coding knowledge (CPT, HCPC, ICD-10, Revenue, DRG, or other relevant medical and industry-standard codes) strongly preferred
• Demonstrated ability to meet deadlines
• Strong commitment to quality and service
• Strong verbal and written communication

This position is a remote role and will work remotely 100% of the time. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.

The full salary grade for this position is $56,600 - $97,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $56,600 - $84,840. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US:

Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.