Director, Configuration Management

SCAN Health Insurance•Long Beach, CA

2d•$147,900 - $214,030•Remote

About The Position

The Director, Configuration Mgmt captures and defines requirements to create, validate, analyze, monitor and maintain critical reports for key department metrics. Responsible for continuous quality improvement of Configuration software applications, including management and oversight of system administration maintenance activities including system/user error reporting/tracking through resolution, enhancement testing validation through implementation, coordination of manufacture upgrades/releases with SCAN IT support and replacement software selection. You Will Directs the daily operations of programs and applications for a team of 9-10 configuration resources including oversight of program and system activities, hiring and training of staff, staff evaluation including competency assessment and program audits, performance appraisals and regulatory and operational reporting. Initiates and reviews program and application metrics for productivity and efficacy in support of the organization’s mission and goals. Tracks and trends activities and outcomes to identify opportunities to improve service, quality of care and program efficiency. Assures that configuration team has standard Policy and Procedures, desktop procedures, training materials, and program communications are current and accurately reflect the processes and regulatory requirements. Ensures that configuration applications meet both current and future needs in support of organizational initiatives. Provides central program and application ownership by representing the interests of and acting as subject matter expert regarding configuration programs and applications at internal committees as needed such as Quality Committees, Information Technology Governance Committee, and Strategic and Operational Project Workgroups.Achieves financial objectives by preparing an annual budget, approving appropriate expenditures, analyzing variances, and initiating corrective action. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Promotes compliance with and adheres to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies’ standards such as the National Committee for Quality Assurance (NCQA) as it relates to the Performance Management and Clinical Systems activities. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Contributes to team effort by accomplishing related results as needed. Resource has industry certifications such as the Certified Medical Reimbursement Specialist (CMRS) certification from American Medical Billing Association (AMBA). We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Requirements

Graduate or Advanced Degree or equivalent experience preferred in Healthcare or human service-related field, or RN with bachelor’s degree
8 years of experience in a Managed Health Care setting, Medicare/Medicaid
5 years of leadership experience preferred
Basic knowledge of related NCQA standards, CMS and DHS regulations
Understanding of System Development Life Cycle
Strong healthcare program development, quality and analysis skills including understanding of basic research methods, and ability to make decisions accordingly
Excellent presentation skills; group motivation and supervisory skills
Strong strategic planning, critical thinking and leadership skills
Strong verbal and written communication skills
Resource has industry certifications such as the Certified Medical Reimbursement Specialist (CMRS) certification from American Medical Billing Association (AMBA).
Curious about AI and its power to transform how we operate and serve our members.

Responsibilities

Captures and defines requirements to create, validate, analyze, monitor and maintain critical reports for key department metrics.
Responsible for continuous quality improvement of Configuration software applications.
Manages and oversees system administration maintenance activities including system/user error reporting/tracking through resolution, enhancement testing validation through implementation, coordination of manufacture upgrades/releases with SCAN IT support and replacement software selection.
Directs the daily operations of programs and applications for a team of 9-10 configuration resources.
Oversees program and system activities, hiring and training of staff, staff evaluation including competency assessment and program audits, performance appraisals and regulatory and operational reporting.
Initiates and reviews program and application metrics for productivity and efficacy in support of the organization’s mission and goals.
Tracks and trends activities and outcomes to identify opportunities to improve service, quality of care and program efficiency.
Assures that configuration team has standard Policy and Procedures, desktop procedures, training materials, and program communications are current and accurately reflect the processes and regulatory requirements.
Ensures that configuration applications meet both current and future needs in support of organizational initiatives.
Provides central program and application ownership by representing the interests of and acting as subject matter expert regarding configuration programs and applications at internal committees.
Achieves financial objectives by preparing an annual budget, approving appropriate expenditures, analyzing variances, and initiating corrective action.
Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
Promotes compliance with and adheres to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies’ standards such as the National Committee for Quality Assurance (NCQA) as it relates to the Performance Management and Clinical Systems activities.
Contributes to team effort by accomplishing related results as needed.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base Pay Range: $147,900-$214,030
Salary Work Mode: Mostly Remote
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
Excellent 401(k) Retirement Saving Plan with employer match
Robust employee recognition program
Tuition reimbursement
An opportunity to become part of a team that makes a difference to our members and our community every day!
A competitive compensation and benefits program
Excellent Retirement Savings program
A work-life balance