Director, Configuration

Morgan Consulting Resources, Inc. has been retained by L.A. Care Health Plan to conduct the search for a Director, Configuration. This position is based in Los Angeles, CA, with a hybrid schedule.

About L.A. Care Health Plan

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

About the Director, Configuration

Reporting to the Senior Director, Core Administrative Operations, the Director, Configuration will play a key leadership role in L.A. Care’s multi-year transformation of its core administrative operations, focused on improving accuracy, reliability, and performance across the claims ecosystem. This role is central to repositioning configuration as a true preventative control function, strengthening upstream processes to reduce downstream defects and drive more consistent, high-quality claims outcomes.

This leader will be responsible for building and advancing a more disciplined, scalable, and enterprise-integrated configuration capability within the QNXT platform. With broad cross-functional visibility, the Director will partner across operations, IT, and compliance to elevate governance, standardization, and execution, helping shape a more predictable, efficient, and high-performing operating environment.

Experience Requirements 

This leader brings deep expertise in managed care configuration (QNXT preferred), along with a track record of leading teams and implementing structured, high-reliability processes in complex, regulated environments.

The ideal candidate is both technically grounded and strategically oriented, with the ability to translate operational and regulatory requirements into scalable system solutions.

• At least 7 years of experience in a system configuration or managed care operations involving core administrative platforms (e.g. Cognizant QNXT).
• At least 5 years of experience leading, supervising and/or managing staff in technical or operational environments.
• Significant experience configuring benefits, pricing methodologies, provider payment logic, and related adjudication rules.
• Extensive knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD)-10, DRG/ Ambulatory Payment Classification (APC), and pricing methodologies.
• Advanced knowledge of and experience with American Health Information Management Association (AHIMA) coding standards.
• Knowledge of and experience with utilizing Systems Development Life Cycle (SDLC), configuration change management methodologies, testing protocols, document standards, and best practices.
• Experience supporting audits, corrective actions, and regulatory reviews.

Mission · Vision · Values 

L.A. Care’s mission is to provide access to quality healthcare for Los Angeles County’s vulnerable and low-income residents to support the safety net required to achieve that purpose.

L.A. Care’s vision is a healthy community in which all have access to the health care they need.

Organizational Values:

• Accountable and responsive to the communities we serve and focus on making a difference.
• Reflects a commitment to cultural diversity and the knowledge necessary to serve our members with respect and competence.
• Driven by continuous improvement and innovation and aims for excellence and integrity.
• Demonstrates L.A. Care’s leadership by active engagement in community, statewide and national collaborations and initiatives aimed at improving the lives of vulnerable low-income individuals and families.
• Fosters and honors strong relationships with our health care providers and the safety net.
• Empowers our members, by providing health care choices and education and encouraging their input as partners in improving their health.
• Puts people first, recognizing the centrality of our members and the staff who serve them.

Benefits: Paid Time Off (PTO; tuition reimbursement; retirement plans; medical, dental & vision; wellness program; volunteer time off (VTO).