Manager, Configuration Center of Excellence

Medica•Madison, WI

2h•$100,300 - $150,465•Hybrid

About The Position

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.

Requirements

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
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
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.

Nice To Haves

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

Responsibilities

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
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
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
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
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