Manager, Configuration (Production Support Team)

Molina Healthcare is a managed care organization serving Medicaid, Medicare, and Marketplace populations. The Manager, Configuration leads a production support team responsible for stabilizing custom claims processing solutions, overseeing root cause analysis, issue resolution, monitoring, reporting, and post-deployment warranty reviews. The role also manages team development, cross-functional investigations, performance improvement, and operational compliance.

Responsibilities:

• Manages technical production support configuration resources, and demonstrates accountability for team performance - including meeting or exceeding established performance targets
• Oversee root cause analysis (RCA) for complex production issues reported by Claims, Health Plans, IT, and other stakeholders ensuring issues are investigated using a structured, fact-based approach that identifies the underlying cause rather than focusing solely on immediate symptoms
• Represents as primary liaison and technical expert with various functional areas/stakeholders (i.e. utilization management, claims, configuration, provider network, health plan leadership, etc.) to handle escalated issues. Facilitate cross-functional meetings and discussions involving complex or high-priority production issues
• Participates in and contributes to the development of custom solution defect strategies to meet business needs
• Analyze production issues occurring to determine whether they represent implementation defects, configuration issues, requirements gaps, operational issues, or other root causes
• Translate technical findings into clear, concise communications appropriate for both technical and business audiences
• Lead the 30-day warranty review process for newly deployed or implemented custom solutions to validate solution stability, performance, and business outcomes following production deployment
• Provide leadership with reporting on warranty outcomes, including significant issues, recurring trends, root causes, and opportunities for improvement
• Plans for daily priorities, and responds to new priorities and opportunities assigned by leadership
• Establish and maintain processes, standards, and documentation for production support, root cause analysis, impact reporting, issue management, and post-deployment warranty review. Supports review of operational policies, procedures, guidelines, and job aids to ensure compliance with company and government regulations
• Maintain operational metrics and reporting related to issue volumes, severity, aging, root cause, business impact, and resolution trends
• Develops and coaches direct production support team - promoting professional growth and development
• Leads performance improvement activities for the production support function
• Hires, trains, develops and manages team; demonstrates accountability for team performance and achievement of configuration/department-specific goals

Requirements:

• At least 7 years of configuration oversight, claims, auditing, and/or health care operations experience in a managed care organization supporting Medicaid, Medicare, and/or Marketplace programs, or equivalent combination of relevant education and experience
• At least 1 year of management/leadership experience
• Advanced understanding of claims processes
• Advanced ability to identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources
• Ability to write complex SQL queries for impact analysis
• Experience with root cause analysis, incident management, problem management, and impact assessment
• Strong analytical, critical-thinking, and problem-solving skills
• Ability to lead cross-functional investigations involving both business and technical stakeholders
• Strong multitasking ability, and decision-making skills
• Flexibility to meet changing business requirements, and strong commitment to high-quality/on-time delivery
• Ability to work cross-collaboratively in a highly matrixed organization
• High attention to detail
• Strong verbal and written communication skills
• Microsoft Office suite proficiency, including intermediate to advanced Excel abilities (VLOOKUP/Pivot Tables, etc.), and applicable software programs proficiency
• Experience leading analysis and operational teams in a managed care setting
• Experience collaborating with various levels of leadership in a highly matrixed organization
• Deep claims processing, configuration and queries experience