Manager, Configuration (Pricing)

Job Summary:

The Manager, Configuration is responsible for providing leadership and direction to ensure the goals and strategies of the department are successfully achieved.

Essential Functions:

• Provide leadership and direction to ensure the goals and strategies of the department are successfully achieved
• Implement opportunities for process improvement that impact operations, performance and quality Ensure appropriate approvals, testing, and controls are in place and adhere to
• Oversee and ensure that supporting business processes and documentation exists as a basis for system logic
• Maintain and support professional, dental, and facility reimbursement. Stay current on all types of reimbursement methodologies and changing industry standards
• Track production issues and status to ensure proper follow-up and coordination
• Maintain project plans for all projects in which configuration is involved and ensure proper completion of those plans and escalation where timeframes will be changed
• Attend related meetings and ensure configuration approved is implemented in a timely manner
• Develop and implement ticket controls and ensure that proper communication and approvals are in place prior to system implementation
• Escalate issues to appropriate internal resources for resolution
• Oversee and accountable for the timely delivery of all regulatory based configuration related changes
• Participate in strategic planning and implement action plans
• Collaborate with team leads on effective people management strategies such as staffing, coaching and mentoring
• Escalate to management any area of significant resource contention along with recommendations for resolution
• Perform any other job duties as requested

Education and Experience:

• Bachelor's degree or equivalent years of relevant work experience is required
• Minimum of three (3) years of management experience is required
• Minimum of five (5) years of health plan business or systems solutions experience is required
• Minimum of three (3) years Facets and/or NetworX Configuration experience is required
• Healthcare, technology and EDI issues experience is preferred

Competencies, Knowledge and Skills:

• Advanced computer skills and abilities in Facets
• Medical terminology
• Proficient in Microsoft Suite to include, Word, Excel and Access
• Proficient in SQL
• 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 written and verbal communication skills
• Effective listening and critical thinking skills
• Strong interpersonal skills and high level of professionalism
• Effective problem solving skills with attention to detail
• Ability to work independently and within a team environment
• Ability to develop, prioritize and accomplish goals
• Excellent listening and critical thinking skills

Licensure and Certification:

• Certified Professional Coder is preferred

Working Conditions:

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

Compensation Range:
$92,300.00 - $161,600.00 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

Competencies:
- Create an Inclusive Environment
- 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 inclusive environment that welcomes and supports individuals of all backgrounds.