Health Plan Configuration Manager

Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

A Little More About this Role: 

We’re looking for a Health Plan Configuration Manager to join our team. This position leads the team responsible for configuring our claims system and related technologies to enable efficient, accurate and reliable claims processing for customers of our level-funded health plans.  The Manager will also develop systems and processes for managing a backlog of support tickets and performance improvement projects to ensure appropriate prioritization and timely resolution.

You will:

·       Lead the team that deploys and maintains benefit plans for customers of our rapidly-growing health plan.

·       Develop and maintain a logical taxonomy of benefit categories, networks, plans, and other configuration structures.

·       Improve the efficiency and reliability of our claims processes through regular review and optimization of configuration logic.

·       Interact with vendor partners to exchange data and EDI files.

·       Analyze plan designs and benefit policies and provide rigorous interpretation and translation into benefit configurations.

·       Develop a roadmap of automation projects and regularly deploy updates that yield measurable efficiency and quality improvements.

·       Ensure all policies and procedures are clearly documented, complied with, and followed up with appropriate QA review.

·       Create, update, and maintain workflows and training needs for the team.

·       Serve as a subject matter expert for Gravie’s claims system.

·       Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.

You bring:

·       5+ years of claims system subject matter expert experience including EDI files and claims processing system

·       Experience leading and mentoring a team

·       Demonstrated ability to work independently, and to effectively manage time-critical issues

·       Ability to deal with ambiguity, shift gears comfortably, and take action without having the total picture

·       Proven ability to make decisions, positively influence others, and work well in a fast-moving environment

·       Strong organizational, time management and prioritization skills

·       Ability to learn quickly, follow directions, and follow through accurately and timely

Extra credit:

·     Javelina or similar claims processing system

·       EDI file types EDI 837, 834 or 835

·       Experience working in a startup environment

Gravie: 

In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.

The salary range for this position is $83,300 to $138,800 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered when determining compensation.

Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave. 

A Little More About Us:

●       We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.

●       We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.

●       Our customers like us. Our revenue churn is in the low single digits, in an industry where greater than 20% churn is common.

●       Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.