Team Lead Configuration (Facets Benefits Configuration)

Job Summary:

The Team Lead, Configuration - Facets Benefits (Medicaid/Medicare) is responsible for providing direction to team on day to day activities and ensure the goals and strategies of the department are successfully achieved.

Essential Functions:

  • Responsible for day-to-day activities surrounding the knowledge and insight around development and support of medical benefits, provider reimbursement, letters, and clinical editing
  • Guide and direct successful completion of daily tasks.  Responsible for onboarding, training and development of staff
  • Prioritize all work, requests and activities.  Escalate any area of significant resource contention along with recommendation for resolution
  • Track issues and  status to ensure proper follow-up, coordination  with business area and provide solutions
  • Update project that configuration is involved with and coordinate any needed changes with manager
  • Partners with cross functional leadership and vendors to achieve departmental and enterprise goals
  • Lead end to end benefits configuration project implementations
  • Provide management with ticket dashboards.  Identify root cause of issues and appropriate pro-active resolution  to reduce tickets in the future
  • Ensure ticket controls,  communication and approvals are followed prior to system implementation
  • Provide oversight to vendor management tasks conducted by team members.  Ensure timely responses and resolution
  • Assist in auditing system configuration to ensure accuracy and internal controls are in place to minimize potential fraud and abuse and any business issues
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor's degree or equivalent 7 years of relevant work experience is required
  • Minimum of three (3) years of health plan business or systems solutions experience is required
  • Facets configuration experience is required
  • Prior supervisory experience is preferred

Competencies, Knowledge and Skills:

  • Advanced computer skills and Facets skills
  • Strong Facets benefits configuration skills
  • Strong SQL and reporting skills
  • Medical terminology
  • Advanced proficiency in Microsoft Suite to include Word, Excel and Access
  • High level of programming and systems development knowledge
  • Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
  • Demonstrated ability to successfully define a portfolio of initiatives including business requirements gathering, definition/prioritization, project scope definition, project staffing requirements, application configuration, testing approach, training, documentation, reporting strategy,  and change management process
  • Knowledge of regulatory reporting and compliance requirements
  • Excellent listening and critical thinking skills
  • Effective problem solving skills with attention to detail
  • Excellent written and verbal communication skills
  • Ability to work independently and within a team environment
  • Strong interpersonal skills and high level of professionalism
  • Ability to develop, prioritize and accomplish goals
  • Proper medical coding knowledge and claims processing skills

Licensure and Certification:

  • Certified Professional Coder (CPC) is preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$76,700.00 - $122,700.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type: