Manager Benefit Configuration

Lets do great things together!

About Moda
Founded in Oregon in 1955 Moda is proud to be a company of real people committed to quality. Today like then were focused on building a better future for healthcare. That starts by offering outstanding coverage to our members compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Lets be better together.

Job Summary:
This position is responsible for the leadership of the team that configures all benefits (including but not limited to medical dental vision pharmacy etc.) into our core processing system. This includes definition planning design development improvement integration and/or maintenance of the companys benefits and products. Responsible for resource allocation setting deadlines and managing multiple priorities simultaneously. Also responsible for configuration activities in other systems that drive web tools for our providers and members as well as those used by our product development team. Manages the department through standard day to day work as well as a high volume of planned projects annually and ad-hoc projects that arise through the course of business. Assures that there is appropriate training and documentation for the team and coaches staff to success in their positions.

This is a full-time hybrid position based in Portland Oregon.

Pay Range
$92940.40 - $118497.46 (annually) depending on experience.
Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page linked below to be considered for this position.

Dental Vision Pharmacy Life & Disability

Primary Functions:

1. Manages a team of 10-15 including coaching mentoring and skill development for staff to be successful in their positions.
2. Manages and tracks the flow of work from various channels communicating expectations to requestors and management as appropriate.
3. Sets priorities within the team and monitors progress.
4. Establishes departmental standards (quality productivity documentation etc.) and monitors results.
5. Evaluates and modifies policies and processes to assure the highest level of efficiency and quality outcomes.
6. Leads staff through frequent and challenging changes in priorities and processes.
7. Analyzes product business requirements develops and evaluates alternatives prepares proposals and design specifications for complex benefit configuration systems or applications to meet operations identified needs goals and metrics.
8. Evaluates proposals and recommendations for complex benefit configuration considering cost/benefit and resource requirements.
9. Develops the configuration strategy and architecture balancing business need and the sustainment of configuration efficiencies.
10. Evaluates and makes decisions about the design of solutions which result in efficient accurate and quality configuration and maintenance of the companys core and integrated systems.
11. Oversees the coding testing implementation and maintenance of benefit configuration systems to meet client needs.
12. Schedules resources translates major client requirements into configuration modifications; develops plans and schedules for major configuration projects to ensure client satisfaction.
13. Effectively communicates requirements plans and schedules to business stakeholders.
14. Participates with key stakeholders and clients in development of test plans and execution of testing configuration system changes/enhancements.
15. Analyzes and evaluates objectives solves problems and develops requirements and proposals for configuration systems and applications.
16. Development of new configuration concepts; performs analysis and improvement of existing techniques.
17. Ensures configuration decisions and changes are documented timely and in accordance with departmental standards.
18. Responds to inquiries from throughout the organization regarding existing configuration potential configuration and research for issues that are reported.
19. Keeps current with technical changes and improvements within areas of assignment incorporating as needed. This includes participating on industry wide subcommittees sponsored by our system vendors.
20. Develops and maintains cross-functional expertise on configuration that crosses units/departments.

Required Skills & Experience:

1. Bachelors degree in business administration or a related field. Completion of an approved educational program or a minimum of four years of related experience may be accepted in lieu of a degree.
2. Minimum of five years of supervisory or management experience.
3. Proven ability to lead teams through significant and challenging changes.
4. Requires knowledge of advanced technology business applications development process and systems design.
5. Minimum of five years of benefit configuration experience specifically in Facets Extended Enterprise.
6. Proven ability to analyze and recognize potential business impacts for all affected departments with regard to benefit and/or contract changes and to offer probable solutions or alternatives.
7. Health plan operations experience is strongly preferred.
8. Expert database/tools experience is strongly preferred (SQL MS Access etc.).
9. Expert MS Excel skills are strongly preferred.
10. Must be proficient at writing system documentation from a business and technical perspective.
11. Experience developing tools to enable efficient configuration and analysis is required.
12. Strong verbal written and interpersonal communication skills. Ability to listen and respond to information effectively.
13. Ability to work well under pressure work with frequent interruptions and shifting priorities.
14. Ability to come into work on time and on a daily basis.
15. Ability to plan organize and prioritize tasks with competing priorities.
16. Ability to develop and deliver training.
17. Ability to develop and document unit process flows.
18. Ability to work independently with minimal supervision.
19. Maintain confidentiality and project a positive and professional business image.
20. Possess strong problem solving and decision making skills.

Contact with Others & Working Conditions:

• Internally: with Regulatory Sales EPMO Claims Customer Service Data Analytics IT management team and employees with frequently confidential information. Works with outside clients and vendors as needed.

• Extensive PC work and constant shifting of priorities.
• Work in excess of 40 hours per week including evenings and occasional weekends to meet business need.

Together we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race religion color age sex sexual orientation national origin marital status disability veteran status or any other status protected by law. This is applicable to all terms and conditions of employment including recruiting hiring placement promotion termination layoff recall transfer leaves of absences compensation and training.

For more information regarding accommodations please direct your questions to Kristy Nehler & Danielle Baker via email.