Offer summary

Qualifications:

Bachelor's degree or equivalent work experience., Minimum of five years of Benefit Configuration experience in Facets or similar systems., Managed Care or Healthcare industry experience., Prior supervisory experience is preferred..

Key responsibilities:

Oversee daily activities and performance of the Benefit Analyst team.

Manage hiring, onboarding, training, and coaching of staff.

Coordinate with business partners to resolve issues and improve processes.

Ensure compliance with benefit regulations and maintain SOPs.

Job description

Job Summary:

The Team Lead, Benefits Support oversees the day-to-day activities, development, and support of Benefit Analyst Team for all markets and products to ensure department goals and standards are achieved.

Essential Functions:

Supervise the Benefit Analyst team including overseeing day-to-day tasks and performance management to ensure all accuracy metrics and SLAs are being met or exceeded
Responsible for hiring, onboarding, training, coaching and development of benefit analyst staff including completing performance appraisals
Escalate any area of significant resource contention along with recommendation for resolution to BCS leadership
Track issues and status to ensure proper follow-up; coordinate with business partners to provide solutions
Communicate effectively with various internal departments to enhance cross-functional awareness, promote process improvement, and identify root cause resolution of issues
Provide Subject Matter Expertise (SME) on projects and committees
Assist in developing and maintaining department SOPs and supporting process flows; communicate all new or updated processes to the team
Monitor to ensure team is following all SOPs
Ensure compliance with member benefit regulations across all product lines (Essential Health Benefits, CMS requirements, Mental Health Parity, etc.)
Collaborate with Manager and Benefits Analysts to communicate opportunities based on Configuration and Benefit Application best practices
Support Benefit Analyst team as they create and maintain benefit grids and/or configuration templates; provide assistance by working stories if there are any capacity constraints
Develop and utilize reports to analyze data to assist with issue resolution and impact analysis
Collaborate with Quality Audit team on feedback and audit results; work with analyst to ensure understanding of any errors and monitor performance going forward
Perform any other job duties as requested

Education and Experience:

Bachelor's degree in a related field or equivalent years of relevant work experience is required
Minimum of five (5) years of Benefit Configuration experience in Facets or other systems required
Managed Care or Healthcare experience is required
Prior supervisory experience is preferred

Competencies, Knowledge and Skills:

Comprehensive understanding of Benefits and System Configuration Requirements
Understanding of CPT, HCPCS and Diagnosis codes
Ability to lead process development and change management
Advanced proficiency with Microsoft Suite to include Excel, Word, and PowerPoint
Excellent problem-solving skills with attention to detail
Strong service orientation and consulting skills
Proven ability to work collaboratively with all levels of management and external stakeholders
Knowledge of regulatory reporting and compliance requirements
Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
Proven ability to juggle multiple, complex priorities within a changing environment
Excellent written and verbal communication skills
Ability to develop, prioritize and accomplish goals

Licensure and Certification:

None

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time
Ability to travel as required by the needs of the business

Compensation Range:

$81,400.00 - $130,200.00

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. 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):

Salary

Organization Level Competencies