Manager of System Configuration

Community Health Choice; Houston (TX); On-site; USD 110,000 - 150,000; Full time

Job summary

Community Health Choice is seeking a leadership role to manage configurations and oversee development of system applications for Health Plan needs. You will lead the configuration/solutions development team, ensure timely updates, and maintain strong documentation and audits while aligning with Leadership on strategy and improvements.

Requirements include a bachelor’s degree, 5 years of configuration or claims processing experience, 2 years of management, and proficiency in Microsoft Office.

Qualifications

• Bachelor’s degree in Healthcare Admin, Business, or related field.
• 5 years of configuration experience or extensive claims processing knowledge.
• Texas Medicaid knowledge.
• 2 years of management/leadership experience.
• Proficiency with Microsoft Office (Word, Excel, Outlook).

Responsibilities

• Lead the configuration and development of system/applications.
• Develop SOPs and guidelines for the Payment Solutions Configuration Team.
• Ensure timely configuration updates and documentation; testing and audits.
• Maintain compliance with state regulations; monitor claims processing.
• Support project management for major implementations.

Skills

Leadership

Team management

Business communication

Process improvement

Education

Bachelor’s degree in Healthcare Admin, Business, or related field

Tools

Microsoft Office

Job description

This position is responsible for managing specified applications/systems within Community Health Choice (CHC). The person in this role is expected to maintain performance within the designated applications, manage and develop staff, continuously improve the quality of processes, and work with Leadership to implement new ideas defined for Health Plan needs. Lead the configuration/solutions development team in the design, development, deployment and sustainment of business process solutions, software systems/applications. Support all departments and constant monitoring of state regulations to comply with the changes.

JOB SPECIFICATIONS AND CORE COMPETENCIES

40%

Manages and leads the configuration and development of system/applications as assigned. Develops standard operating procedures and guidelines for the Payment Solutions Configuration Team. Ensures the appropriate configuration updates and modifications for applications are made within the agreed upon time frame/departmental standards. Commits to proper documentation, testing is conducted for all system/application changes. Proper reporting and audit protocols are documented and managed to ensure internal controls are met. Reviews ticket/request queues daily to ensure that all state and federal claims processing regulations are being met by Community Health Choice. Establishes and implements short and long-term goals, objectives, policies, and operating procedures for the business applications that link to contractual and statutory regulations; sets appropriate stretch goals and stays focused to persistently drive to meet or exceed those goals. Promotes process efficiency by working with team to reduce unnecessary steps and delays or develop more effective processes.

20%

Acts as a contact for external areas by seeking to understand their business needs, providing information, responding to inquiries, investigating, and resolving problems related to the issues and educating on Health Plan business rules. Ensures ongoing communication and support to meet agreed upon resolutions. Identifies opportunities and makes recommendations to external users for improvements and enhancements; works with other department personnel through the tickets/requests process to determine impacts and feasibility of implementation of modifications and enhancements.

15%

Monitors reported issues and ensures they are assigned to the appropriate area for a resolution within agreed upon timeframes. Reviews frequent issues and works with Leadership to determine and resolve root cause, prevents future occurrences, and reduce degree of business impact. Coordinates efforts of technical and functional team involved in resolutions of reported issues. Enforces policies and procedures to all team members performing issue resolutions. (i.e., escalation of technical and functional issues, resources, and change control). Communicates issue and problem resolution to Leadership. Provides direction to individuals supervised.

15%

Provides support to Project Management Office for major implementation projects. Assists in organizing project teams related to assigned systems/applications to ensure appropriate staff for the projects. Ensures necessary tools and resources are available for completion of project (i.e., vendor, equipment, training). Assists in monitoring implementation project to ensure timely completion during course of project. Assists in analysis of problems encountered in projects. Reviews progress or projects on a periodic basis.

10%

Actively contributes to achievement of departmental goals, as identified in Department’s annual business plan, including specific departmental process improvement plans and other duties as assigned.

QUALIFICATIONS:

Education/Specialized Training/Licensure: Bachelor’s degree in Healthcare Admin, Business, or related field.

Work Experience (Years and Area): 5 years of configuration experience or extensive claims processing knowledge and background. Texas Medicaid knowledge.

Management Experience (Years and Area): 2 Years previous management / leader experience.

Software Proficiencies: Microsoft Office (Word, Excel, Outlook)