Manager, Configuration Center of Excellence

Job Description

Job 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.

Medica's Manager, Configuration Center of Excellence (COE), leads a team of Business Analysts and Quality Auditors that support configuration delivery across the organization. The COE provides audit oversight, claims impact analysis, process improvement, requirements management, training, documentation, reporting, and operational support to configuration teams. This role is responsible for establishing and advancing the COE's strategy, governance framework, operating standards, and best practices.

The Manager partners closely with Configuration Delivery, Configuration Architecture, Product Design, Information Technology, Claims, Internal Audit, Operations Training and Readiness, and other business stakeholders to improve configuration quality, reduce operational risk, increase visibility, and support scalable delivery processes.

Initially, this leader will focus on clarifying responsibilities across the Business Analyst and Quality Auditor functions, improving work assignment and visibility, and preparing the COE to support additional configuration teams. The role will also identify opportunities to strengthen quality controls, improve operational efficiency, and expand the value delivered by the COE. Performs other duties as assigned. 

Key Accountabilities

Configuration Quality, Auditing, and Governance (25%)

• Establish and maintain configuration quality standards, audit frameworks, and governance processes
• Oversee production, operational, service, and ad hoc configuration audits
• Develop audit methodologies, quality controls, documentation standards, and reporting processes
• Monitor completed configuration work to identify errors, trends, risks, and opportunities for improvement
• Communicate audit findings and recommendations to Configuration Delivery leadership
• Partner with Business Analysts and operational teams to address recurring process issues
• Support corporate audit activities, including regulatory, compliance, and internal audit reviews
• Maintain centralized audit documentation, findings, and historical reporting
• Ensure adherence to configuration standards, internal controls, and regulatory requirements

Operational Excellence, Process Improvement, and Claims Impact Support (25%)

• Lead continuous improvement initiatives across business configuration operations
• Oversee claims impact reporting related to retroactive configuration changes
• Partner with Claims and Configuration Delivery teams to support claims reprocessing efforts
• Analyze root causes of retroactive changes, including configuration errors, requirements gaps, and operational delays
• Recommend process improvements, training opportunities, and enhanced controls based on findings
• Improve work intake, prioritization, assignment, tracking, and visibility processes
• Collaborate with business and technology teams to identify automation opportunities
• Establish operational standards that support consistency, efficiency, and scalability
• Measure and communicate business outcomes and operational improvements

Training, Onboarding, and Knowledge Management (15%)

• Oversee development and maintenance of training materials, job aids, standard operating procedures, process flows, and configuration documentation
• Coordinate training programs with configuration leadership, subject matter experts, and learning partners
• Identify training needs based on audit results, operational trends, and business requirements
• Support onboarding, cross-training, and ongoing employee development initiatives
• Ensure training and process documentation remains current and accurate
• Foster knowledge sharing and best practice adoption across configuration teams

Project Support, Requirements Management, and Strategic Initiatives (15%)

• Lead Business Analyst support for configuration and enterprise-wide initiatives
• Establish standards and best practices for business requirements gathering and documentation
• Partner with stakeholders to define requirements and translate business needs into actionable solutions
• Support implementation planning and transition activities from project delivery to operations
• Advise stakeholders on configuration impacts, risks, dependencies, and implementation considerations
• Promote governance, documentation, and stakeholder alignment throughout project lifecycles
• Expand COE support capabilities across benefits, claims, provider, health services, and other configuration functions

Leadership, Reporting, and Team Development (20%)

• Lead, coach, and develop a team of Business Analysts and Quality Auditors
• Define roles, responsibilities, and workload distribution across the COE
• Establish team goals, priorities, and performance expectations aligned with organizational objectives
• Foster a collaborative and inclusive environment that supports employee engagement and professional growth
• Develop and monitor quality metrics, operational KPIs, dashboards, and reporting
• Present findings, trends, risks, and recommendations to leadership
• Build strong partnerships across Configuration, Claims, Operations, Technology, Compliance, and Audit functions
• Identify emerging business needs and drive initiatives that improve configuration delivery effectiveness
• Develop roadmaps and strategic plans that support the continued growth and maturity of the COE

Required Qualifications

• Bachelor's degree in Business Administration, Management Information Systems, Information Technology, Healthcare Administration, or a related field, or equivalent combination of education and experience
• 5+ years of experience in healthcare operations, business configuration, business analysis, quality assurance, process improvement, or a related area
• 2+ years of people leadership experience

Preferred Qualifications

• Experience working within the HealthRules Payor ecosystem
• Experience leading operational improvement initiatives or developing new business functions
• Experience supporting healthcare payer operations and cross-functional business teams
• Experience leading teams responsible for reporting, analysis, auditing, project support, or process improvement
• Hands-on healthcare configuration experience
• Experience supporting benefits, claims, provider, or health services configuration functions
• Experience with GuidingCare or other healthcare administration platforms
• Experience establishing, expanding, or leading a Center of Excellence
• Experience leading automation, process optimization, or operational maturity initiatives
• Lean Six Sigma Green Belt (or higher)
• Project Management Professional (PMP) certification
• Certified Business Analysis Professional (CBAP) certification
• Quality Management or Operational Excellence certification

Skills and Abilities

• Knowledge of healthcare payer operations, claims processing, benefits configuration, provider reimbursement, and related business functions
• Understanding of configuration delivery processes and the operational impact of configuration changes
• Experience developing governance frameworks, standards, and operational processes
• Experience with business analysis, requirements management, and project facilitation
• Ability to analyze audit findings, operational data, trends, and risks
• Experience developing and managing performance metrics, reporting, and dashboards
• Knowledge of quality assurance, compliance, audit, and risk management practices
• Strong analytical, problem-solving, organizational, and prioritization skills
• Ability to communicate complex concepts and findings to technical and non-technical audiences
• Strong written, verbal, presentation, and stakeholder management skills
• Ability to influence decisions and build alignment across departments and leadership levels
• Demonstrated leadership, coaching, employee development, and change management capabilities

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI.

The full salary grade for this position is $100,300 - $172,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $100,300 - $150,465. 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 base compensation, this position may be eligible for incentive plan compensation in addition to base salary. 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.

Internal Applicants: We’re excited about your interest in growing your career at Medica! To be eligible to apply for internal opportunities, employees must have been in their current role for at least one year.

Recruiter: Brandon Dehn

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.