The Manager of Configuration Services ensures that the performance, function, and appearance of our products are consistent in our claims system(s). This involves managing the requirements, design and operational information throughout the products lifecycle. The Manager develops production migration plans and oversees the deployment. This role brings both a tactical and strategic point of view to assist in refining ongoing operational improvements. This position is responsible for:
- Develops, implements, reviews, analyzes, and improves audit quality standards across claims and configuration programs and procedures, ensuring they are designed to drive accuracy and quality results in support of the organizations vision, mission, and strategic goals.
- Management and oversight of staff resources in compliance with all departmental policies, procedures, and internal service level agreements
- Manages the Configuration Services Process, configures and builds necessary reports and establishes key metrics
- Manages the Configuration Services duties including but not limited to, review of requirements, oversight of usecase and documentation creation, analysis of inventory to support the prioritization of corporate issues
- Serves as point of escalation for business partners when applicable
- Manages system vendor and their adherence to configuration priorities, service level agreements and contract terms within agreed upon contract
- Reports and communicates status, corporate impacts and risks of all Operation Services configuration to Senior Management
- Work closely with Manager of Business Solutions, Project Managers, the Production Support Manager to ensure compliance to the System Development Life Cycle (SDLC) and the change approval process
- Actively participates in change management activities
- Provides estimates for issue resolutions relative to configuration
- Oversee process development and documentation for any new or altered functionality or business process flows.
Duties and Responsibilities Responsibilities include, but are not limited to:
- Serves as primary contact for all work assigned to the team
- Develops and implements strategies to simplify processes for team
- Designs and develops workflows, protocols, and process models for use with Configuration Services team
- Prioritizes Configuration Services business needs.
- Ensures timely performance feedback and opportunities for staff development
- Triages, analyzes, and reviews issues submitted in the JIRA application and assigns/redirects accordingly
- Manages quarterly code load and NUBC process within the Configuration Services team
- Responsible for the adherence of the change management process
- Contribute to development of business requirements, functional requirements, process flows, reference materials, user guides and code release artifacts pertaining to system upgrades
- Oversees and manages claims processing system defects
- Responsible for reconciliation of vendor budgeting
- Manages the prioritization process and submission of priorities to vendors
- Manages vendor expectations and adherence to priorities and escalates to as required
- Apply industry-specific expertise to recommend and coordinate the development, enhancement and maintenance of a departments processes and procedures
- Represent Configuration Services team for all corporate wide initiatives
- Resolves issues within internal departments related to configuration and defects
- Manages the Configuration Services Process and system development life cycles for defects, issues, and enhancements
- Engage in on-going performance management of staff including coaching, mentoring, development, training, and succession planning to include hiring and termination decisions
- Report to senior leadership project and workload allocation (managing staff, inventory and escalations and reporting up to sr. leadership as needed)
- Team reporting including, but not limited to SLA metrics, testing, quality, documentation
- Work closely with Project Managers, the Production Support Manager to ensure compliance to the System Development Life Cycle (SDLC) and the change approval process
- Collaborate with internal business partners to streamline processes
- Manages business partner expectations, and internal adherence to service level agreements
- Manages vendor performance and reports non-adherence of Service Level Agreements to Senior Management.
- Reviews regulatory guidance, contracts and statement of work and ensures adherence to the terms therein
- Hands on with more complex assignments (as needed) to the point of being handed off to team member
- Oversees process development and documentation for new or altered functionality or business process.
- Develop and maintain standards for development of business processes and cases and their documentation
- Ownership of business process audit procedure
- As required, prepare and compile periodic progress reports to the Senior Management Team.
- Coordinates multiple simultaneous projects and initiatives.
- Performs other duties as assigned
- Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents
Qualifications Required:
- Bachelors Degree or equivalent education and years of relevant work experience and background to equate to the degree
- Five (5) + years of related business analysis/business systems analysis/defect management experience or comparable business experience.
- Three (3) years of managed care/health care experience
- Strong interpersonal skills, with the ability to interact effectively with all levels of managerial, professional, technical, and clerical staff. Ability to create strong relationships with business partners
- Intermediate to Advanced skills in Microsoft Office (Word, Excel, PowerPoint, Outlook, Visio, Project)
- Strong use of data mining and analysis tools including SQL or similar tools that allow for data queries
- Must be a strategic thinker working independently with strong analytical skills, work ethic, attention to detail and the ability to perform and/or critique quantitative analyses, regulatory assessments, and operational plans
- Capable of utilizing IT data for business insights and analyzing business needs
- Strong ability to evaluate the performance of project teams to ensure the targets and deadlines are met
- Strong ability to communicate and document timelines and set expectations with business customers
- Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment with accurate resource and time estimates
- Confident team builder and leader with strong motivational skills. Adept in problem solving and resolving conflict
- Experience in mentoring and training colleagues
- Must be accountable and be able to hold others accountable for the adherence to policies, procedures, and standards
- Must have outstanding time management and organizational skills
- Solid organization, negotiation, and analysis skills with demonstrated ability to deliver on multiple assignments meet tight deadlines and are effective and decisive under pressure.
- Ability to liaise with business users, developers, vendors, stakeholders, analysts, and management to drive resolution for system defects and enhancements.
- Strong communication skills, both verbal and written with attention to detail
Preferred:
- Extensive experience in an insurance, medical and/or HMO environment using claims processing software
- Three (3) + years of experience in a team lead or leadership role
- Experienced in the use of JIRA or similar ticketing system
- Experience in Healthcare
- Experienced in the use of Cognos or similar tool
- Experience in demonstrating leadership, influence, and collaboration in a matrix-managed environment
- Experience in claims or systems analysis
- Experience in Visio and Microsoft Access
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Neighborhood Health Plan of Rhode Island
Mar 03, 2026