• Own the end-to-end claims configuration function, including benefits and plan design, pricing logic, accumulator logic, provider data, edits, networks, and adjudication rules • Establish configuration standards, including maintenance of standard codes, naming conventions, and benefit category architecture • Create and maintain a user-friendly configuration documentation library in Gravie’s knowledge management system • Maintain a well-organized configuration task management system • Implement appropriate controls and governance to ensure configuration changes are quality assured • Translate product, regulatory, and contractual requirements into scalable and repeatable configuration solutions • Serve as the subject matter expert on claims configuration capabilities and limitations • Ensure timely and accurate configuration for new products, clients, renewals, and benefit changes • Drive continuous improvement in configuration quality, turnaround time, and defect reduction • Partner with Claims Operations to minimize configuration-driven claim errors • Support root cause analysis of claims issues tied to configuration and implement corrective actions • Collaborate closely with Product, Optimization, Network, Finance, Compliance, Eligibility & Enrollment, and Technology • Create and maintain a balanced scorecard of cost, quality and time metrics with goals • Support product innovation by enabling new benefit designs and network offerings • Partner with Technology on enhancements, automation, testing frameworks, and release management related to systems used for claims processing • Lead, coach, and develop a team of claims configuration professionals • Define roles, workflows, and capacity models to support scale and growth • Support training efforts to ensure configuration knowledge is institutionalized • Ensure configurations comply with regulatory requirements, contractual obligations, and internal policies • Support audits, quality reviews, and regulatory inquiries related to claims configuration • Maintain strong documentation and change management practices to support transparency and traceability