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Claims Configuration Manager Jobs in California (NOW HIRING)

MedImpact

Supervisor, Configuration Services

San Diego, CA · On-site +1

$103K - $131K/yr

We are the premier Pharmacy Benefits Management solution! Summary Supervises configuration team ... Good knowledge of POS claims adjudication, pharmacy benefit design, and formulary maintenance and ...

Scanhealthplan

Claims Analyst

Los Angeles, CA

Validate claims configuration updates following contract implementations, reimbursement changes, or ... Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.

myPlace Health

Claims Analyst

Los Angeles, CA · On-site

Validate claims configuration updates following contract implementations, reimbursement changes, or ... Experience working in a PACE, Medicare Advantage, or Medi-Cal managed-care environment.

Prosper-Services-LL

Claims Analyst

Compton, CA · On-site

Validate claims configuration updates following contract implementations, reimbursement changes, or ... managed-care environment.Experience with Athena, VisibilEDI, or integrations between electronic ...

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Claims Configuration Manager information

What cities in California are hiring for Claims Configuration Manager jobs?

Cities in California with the most Claims Configuration Manager job openings:

Infographic showing various Claims Configuration Manager job openings in California as of July 2026, with employment types broken down into 89% Full Time, 10% Part Time, and 1% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution.

Program Manager (Claims - MST hours)

Long Beach, CA • On-site

Molina Healthcare
Health Care and Social Assistance • 10K+ employees
Learn more about Molina Healthcareexternal

$66K - $129K/yr

Full-time

Re-posted 20 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

172nd of 315 rated insurance

Job description

JOB DESCRIPTION

Job Summary

Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable. 

Job Duties

  • Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective claims & claims configuration program.     
  • Manages program budget, as applicable, supporting project prioritization.
  • Collaborates with Legal, Compliance, and Information Security to ensure governance standards are upheld.
  • Tracks performance metrics and ensures value realization from deployed solutions. 
  • Coordinates recurring meetings to support governance framework and decision-making processes, as needed. 
  • At the direction of program (CoE, Shared Service or other functional area) leadership, supports portfolio management and/or initiative-specific change and project management.
  • Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral.
  • Routinely reviews program collateral to ensure current and accurate reflection of business needs. 
  • Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team. 
  • Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
  • Generates and distributes standard reports on schedule.

JOB QUALIFICATIONS

REQUIRED QUALIFICATIONS:

  • At least 4 years of Program and/or Project management experience, or equivalent combination of relevant education and experience.
  • Operational Process Improvement experience.
  • Managed Care experience, preferably in a shared service, CoE or matrixed environment.
  • Experience with Microsoft Project and Visio. 
  • Strong presentation and communication skills.

PREFERRED QUALIFICATIONS:

  • Clams & claims configuration experience.
  • QNXT
  • Provider Relations

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $66,456 - $129,590 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

Social media

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