Director, Configuration (EDI & Inbound Claims)

Experteer Overview In this role, you lead a team responsible for delivering and maintaining enterprise products that support operations. You’ll drive the product vision, manage the backlog, and align delivery with business outcomes, regulatory requirements, and enterprise strategy. You’ll partner with engineering, data, QA, and operations to ensure feasible, scalable solutions. This position sits at the intersection of business stakeholders and technical delivery teams, shaping how benefits, contracts, and configurations are implemented. Compensation / Benefits * Direct a configuration team to meet performance targets and regulatory requirements * Hire, train, and develop team; drive department goals * Coordinate department activities for efficiency and prioritization * Plan and optimize configuration workflow processes * Identify operational efficiencies and best practices * Allocate resources and escalate needs to leadership * Ensure compliance with federal/state regulations and internal policies * Own and communicate a clear product vision aligned to enterprise strategy * Partner with stakeholders to understand problems, desired outcomes, and regulatory obligations * Direct development/maintenance of contract, benefit configuration, and fee schedules * Oversee member benefit implementations in claims/payment systems * Provide systematic solutions for business processes and strategic planning * Build relationships with health plan leadership and cross-functional teams * Collaborate with engineering, data, QA, operations, and health plans to ensure feasibility and scalability * Support reviews with compliance, legal, and audit teams * Promote standardization and reduction of unmanaged complexity * Translate stakeholder requirements into backlog items Tasks * 8+ years in product ownership/management or technical delivery * 3+ years in management/leadership * Experience with Agile/Scrum delivery models * Experience with enterprise platforms, configuration tools, data solutions, integrations, or operational systems * Strong understanding of software development lifecycles and Agile principles * Proven ability to write clear, testable user stories and acceptance criteria * Experience prioritizing work in highly regulated environments * Strong analytical and problem-solving skills * Excellent communication and stakeholder influence abilities * Ability to operate in ambiguity and make decisions with incomplete information Key requirements * competitive benefits and compensation package

internal policies * Own and communicate a clear product vision aligned to enterprise strategy * Partner with stakeholders to understand problems, desired outcomes, and regulatory obligations * Direct development/maintenance of contract, benefit configuration, and fee schedules * Oversee member benefit implementations in claims/payment systems * Provide systematic solutions for business processes and strategic planning * Build relationships with health plan leadership and cross-functional teams * Collaborate with engineering, data, QA, operations, and health plans to ensure feasibility and scalability * Support reviews with compliance, legal, and audit teams * Promote standardization and reduction of unmanaged complexity * Translate stakeholder requirements into backlog items Tasks * 8+ years in product ownership/management or technical delivery * 3+ years in management/leadership * Experience with Agile/Scrum delivery models * Experience with enterprise platforms, configuration tools, data solutions, integrations, or operational systems * Strong understanding of software development lifecycles and Agile principles * Proven ability to write clear, testable user stories and acceptance criteria * Experience prioritizing work in highly regulated environments * Strong analytical and problem-solving skills * Excellent communication and stakeholder influence abilities * Ability to operate in ambiguity and make decisions with incomplete information Key requirements * competitive benefits and compensation package