Responsible for ensuring accurate benefit, contract, and claim edit configuration within the claim processing system.
Proactively identifies trends, analyzes configuration impacts, and recommends solutions.
Investigates issues, coordinates updates, supports state complaint responses, and drives continuous improvement across claim operations.
Collaborates closely with Configuration leadership and cross-functional partners such as Provider Relations, Claims, Appeals & Grievances, and Compliance.

5+ years of experience with Texas Medicaid benefits, services, and regulatory requirements, with demonstrated ability to interpret and apply policy changes.
5+ years of experience in managed care, claims processing, or configuration within MCO operations.
3+ years of experience managing projects driven by Medicaid policy changes, operational improvements, or system configuration updates.
Experience collaborating across cross-functional teams and contributing to complex operational initiatives.

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

Manager, Configuration & Claims Analytics

Key skills