Skip to content
CV Rocket
Get started
How it worksThe enginePricingBlogContactSign in

Open nowPosted today

Manager, Pricing Configuration

CareMore Health18 open roles

Pay
$130,159 – $195,238 a year
Where
California, USA
Get the CV for this job

From $25 per CV, paid once. No subscription.

Your applicationOpen nowManager, Pricing ConfigurationCareMore Health · California, USA

  1. YouYes, apply to this one.

  2. CV RocketCV written for this posting.

  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

  4. CV RocketApplied on CareMore Health's own form.

The reply lands in your private mailbox

3×more interviews than doing it yourself with ChatGPT.

The clock on this job

Early applications get read.

13.3% of postings close within 7 days. Measured by our own scanner across the market. CareMore Health postings stay open a median of 23 days.

Share of postings closed within
  1. 2.1%1 day
  2. 4.6%3 days
  3. 13.3%7 days
  4. 21.3%14 days
  5. 35.7%30 days
  6. 59.1%60 days
This job: posted today

CareMore Health median: 23 days open

The posting

Job Description Summary

‎

Manages the Pricing Configuration team responsible for translating provider contracts, reimbursement schedules, benefit requirements, and business rules into accurate claims adjudication system configurations. Oversees pricing and benefit configuration activities, fee schedule maintenance, configuration audits, and resolution of discrepancies affecting provider payments. Coordinates with Contracting, Claims, IT, and other operational teams to maintain configuration accuracy, support timely implementation of changes, and improve claims processing efficiency.

Manager, Pricing Configuration leads a team of professionals with accountability for operational results over a short-term horizon of up to six months. Decisions impact team output and short-term functional performance. This job plans and establishes team goals, manages headcount and resources within the team, coaches direct reports through performance cycles, and coordinates across teams to ensure consistent execution.

‎

How will you make an impact & Requirements

‎

KEY RESPONSIBILITIES

· Manage and develop Pricing Configuration analysts, including assigning work, establishing priorities, monitoring performance, providing coaching and technical guidance, and supporting hiring and employee development activities.

· Direct daily pricing and benefit configuration operations, including workload planning, capacity allocation, service-level monitoring, backlog management, and timely completion of configuration requests.

· Oversee the setup, maintenance, and validation of provider reimbursement arrangements, contracted rates, capitation structures, CMS fee schedules, and benefit configurations within TriZetto Facets and related claims adjudication systems.

· Coordinate with Network Contracting, Claims, Provider Data Management, Finance, and IT to translate contractual requirements, reimbursement methodologies, benefit designs, and business rules into accurate system configurations.

· Establish and monitor configuration quality controls, including pre- and post-implementation audits, peer reviews, testing documentation, change records, and production validation to support accurate provider payments.

· Lead investigation and resolution of configuration-related claims processing errors, pricing discrepancies, benefit calculation issues, and payment exceptions. Coordinate corrective actions and identify opportunities to reduce rework and increase accurate auto-adjudication.

· Coordinate configuration activities for system upgrades, releases, regulatory updates, and implementation projects. Monitor operational risks, report performance results, and escalate material issues to the Director.

QUALIFICATIONS

· Bachelor's degree in Information Technology, Healthcare Administration, Business, or a related field required; an equivalent combination of education and relevant healthcare payer operations experience may be considered.

· At least 7 years of progressive experience in healthcare payer operations, claims adjudication, provider reimbursement, or pricing and benefit configuration, including at least 3 years of direct people-management experience.

· Advanced knowledge of healthcare provider reimbursement methodologies, contracted pricing arrangements, capitation, CMS fee schedules, benefit configuration, cost-share calculations, and claims adjudication processes.

· Experience configuring, maintaining, testing, and auditing reimbursement and benefit arrangements within TriZetto Facets or a comparable healthcare payer claims administration platform. Experience with the Facets Configuration Management Utility preferred.

· Demonstrated experience with configuration quality assurance, change control, system implementations, release testing, production troubleshooting, and root cause analysis. Working knowledge of SQL-based validation, healthcare coding standards, and electronic claims transactions preferred.

· Strong analytical, organizational, communication, and leadership skills, with demonstrated ability to manage competing priorities, develop technical employees, coordinate cross-functional work, and resolve complex operational issues.

‎

Compensation Range:

$130,159.00

to

$195,238.00

The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.

From $25, paid onceGet the CV for this job

What happens when you press

One press. We do the rest.

  1. A CV for this posting

    Written against CareMore Health's own wording, from every piece of relevant proof in your profile.

  2. 25 readers review it

    Recruiter, hiring manager, skeptic and more read every draft, round after round. You get the best round.

    The review screen in CV Rocket: how each CV was read, round by round.

  3. We apply on CareMore Health's form

    Our application engine gets through the hardest forms there are. Where a question needs you, AI suggests the best answer. Don't want us applying from our IP addresses? Use our Chrome extension: we apply straight from your own browser.

    An application in CV Rocket: every answer filled in on the employer's form.

  4. Every reply, sorted

    CareMore Health's answer lands in your private mailbox, and we classify it on arrival: interview, question, rejection.

    The CV Rocket inbox: each employer reply classified as an interview, an action or a rejection.

  5. Reply with AI

    AI helps you write the email, checks it and sends it. We show you whether the recruiter read it.

  6. The interview in your calendar

    Full integration with your calendar. The invitation goes straight in.

    An interview invitation in the CV Rocket inbox, added to the candidate's calendar.
Get the CV for this job

From $25 per CV, paid once. No subscription.

Why it works

3×

more interviews than doing it yourself with ChatGPT.

ChatGPT writes a CV and never learns what happened to it. We see every reply. For each CV we know:

  • How it was written, and how the review scored it
  • When we applied, and how long after the posting went up
  • Which posting, which company, which city
  • Who got the interview, and who heard nothing

That is how we know which CVs get called.

Get the CV for this job

From $25 per CV, paid once. No subscription.

The numbers game

More applications. More interviews.

Every application goes out with its own CV, written for that posting and paid once. Send enough of them and the law of large numbers finds you the job.

Get the CV for this job
By hand5–10
With CV Rocket100
applications a day

Nearby

Live postings like this one

Same employer first, then the same role elsewhere.

Before you press

Straight answers

Get the CV for this job

From $25 per CV, paid once. No subscription.

What if my background isn't good enough?

We make the most of the background you have. The CV uses every piece of relevant proof your profile holds, and one of the 25 readers reads your whole profile and flags what the CV left out.

Do you really apply for me?

Yes, on the employer's own form, the hardest ones included. Where a question needs you, you answer it right there and AI suggests the best answer. Don't want us applying from our IP addresses? Use our Chrome extension: we apply straight from your own browser.

Is it a subscription?

No. You pay once per CV, from $25. Every application goes out with its own CV, written for that posting.

One job. One CV.
Paid once.

Pick the posting you want. We write for it, apply for you and catch the reply.

Get the CV for this job

From $25 per CV, paid once. No subscription.