Team Lead Configuration (Facets Benefits Configuration)
- Req. Number: R6508
- Location: Remote
- Posted Date: 11/8/2023
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