Manager, Configuration Center of Excellence

Medica • Minnetonka, MN

3d • Hybrid

About The Position

Medica is a nonprofit health plan serving over a million members across several states. The Manager, Configuration Center of Excellence (COE) leads a team of Business Analysts and Quality Auditors responsible for 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 crucial for establishing and advancing the COE's strategy, governance framework, operating standards, and best practices. The Manager collaborates with various departments including Configuration Delivery, Configuration Architecture, Product Design, Information Technology, Claims, Internal Audit, Operations Training and Readiness, and other business stakeholders to enhance configuration quality, mitigate operational risks, improve visibility, and support scalable delivery processes. Initially, the focus will be on clarifying responsibilities within 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.
• Eligibility to work in the US.
• All candidates must be legally authorized to work in the United States at the time of application.

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.

Benefits

• competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Manager