Job Description
Identify, manage and document the status of open issues. Develop and utilize reports to analyze and stratify data to address gaps and provide answers to issues identified within the department or by other departments, utilizing TriZetto or Optum for research and correction. Utilize available tools provided by relevant State or Federal websites to obtain pertinent Fed/State Regulatory Transmittals and Fee Schedules. Plan/implement new software releases including testing and training. Participate in meetings with business owners and users to achieve a Plan benefit design and Provider Reimbursement. Serve as liaison between IT and business areas to research requirements for IT projects, meet with decision makers to translate IT specifications and define business requirements and system goals. Lead review of benefits or provider reimbursement as well as identify and design appropriate changes. Lead in the development and execution of test plans and scenarios for all benefit or reimbursement designs and for the core business system and related processes. Provide detailed analysis of efficiencies related to system enhancement and automation. Review, analyze, and document the effectiveness and efficiency of existing systems and develop strategies for improving or further leveraging these systems. Conduct preliminary studies to define needs and determine feasibility of system design.
Education Requirements: Bachelor’s degree in Computer Science, Electrical Engineering, Information Technology, related field, or foreign degree equivalent.
Experience Requirements: Three (3) years of experience as a Configuration Analyst using Facets to perform claims testing and to configure benefits models and solutions in the healthcare industry.
Travel: Candidate may work remotely from anywhere in the US.
Compensation Range:
$83,000.00 - $132,800.00CareSource 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. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
Brand=CareSourceOriginally posted on Himalayas
