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:
Salary