Health Plan Configuration Manager

Gravie

1d•$98,000 - $130,000

About The Position

We're looking for a Manager of Health Plan Configuration to oversee the execution of our configuration strategy for the claims system and related technologies across Gravie's rapidly-growing book of level-funded health plans. This leader will report to the Director of Configuration and be responsible for translating the long-term roadmap into day-to-day execution, building and developing a high-performing team and driving accuracy, efficiency, and scalability across our claims configuration infrastructure. This role carries meaningful latitude to shape process, policy, and team structure in service of that vision, and is expected to represent Configuration in cross-functional forums.

Requirements

6+ years of claims system subject matter expertise, including 3+ years leading teams, team leads, or managers in a configuration, claims operations, or healthcare IT function
Demonstrated ability to operate as a strategic partner to senior leadership, not just an executor — translating ambiguous direction into clear plans and driving them to completion
Proven track record influencing senior and executive stakeholders, and driving organizational or process change at scale
Strong executive presence, communication, and cross-functional relationship-building skills
Experience owning budget, vendor contracts, or SLAs, and making resource trade-off decisions
Ability to operate strategically while remaining close enough to the details to guide the team through complex technical and configuration problems
Ability to deal with ambiguity, shift gears comfortably, and take decisive action without having the total picture
Strong organizational, time management, and prioritization skills, with the judgment to know what needs executive visibility versus what the team should own
Working knowledge of EDI transaction standards (837, 835, 834, 278) and how they integrate with claims configuration and adjudication

Nice To Haves

Experience operating in a regulated healthcare or health plan environment
Experience supporting system integrations, or large-scale platform migrations
Previous experience in a startup or high-growth company environment
Experience managing EDI clearinghouse relationships or trading partner onboarding

Responsibilities

Execute the configuration strategy and roadmap, translating vision into actionable priorities and aligning the team with company growth and product objectives
Lead, develop, and scale a team of configuration and EDI analysts, including hiring, mentoring, performance management, and succession planning as the function grows
Partner with the leadership and cross-functional stakeholders (Product, Engineering, Operations, Finance) to align configuration capacity and priorities with broader business initiatives
Manage vendor relationships for configuration-related partners, including SLA monitoring, performance management, and escalation resolution
Develop and maintain a logical taxonomy of benefit categories, networks, plans, and configuration structures
Oversee technical support for claim loading, EDI transactions (837, 835, 278), and related system troubleshooting
Own EDI trading partner and clearinghouse relationships, ensuring compliance with X12 standards and timely resolution of transaction errors
Support execution of the automation roadmap, deploying updates that yield measurable efficiency and quality improvements
Establish and enforce policies, controls, and QA standards for configuration accuracy, ensuring documentation and compliance practices hold up under audit
Manage staffing and resource planning for the configuration function, in partnership with the leadership on broader investment decisions
Provide strategic input and visibility to the Director and executive leadership on KPIs, risk, capacity, and performance trends across Configuration and EDI
Lead cross-functional coordination during high-stakes periods (open enrollment, Q4, system upgrades), managing risk and prioritization across departments
Serve as a senior subject matter expert on Gravie's claims system and configuration operations
Act as the primary escalation point for complex, high-stakes configuration and EDI issues, exercising independent judgment to resolve risk before it reaches leadership
Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic, and outcome oriented