Team Lead, Configuration
About The Position
This role involves identifying, managing, and documenting open issues within the department. The Team Lead will develop and utilize reports to analyze data, address gaps, and resolve issues using TriZetto or Optum. They will also obtain regulatory transmittals and fee schedules from state and federal websites, plan and implement new software releases including testing and training, and participate in meetings with business owners and users to define benefit designs and provider reimbursement. The position serves as a liaison between IT and business areas, translating IT specifications and defining business requirements and system goals. The Team Lead will also lead reviews of benefits and provider reimbursement, identify and design changes, and lead the development and execution of test plans for benefit/reimbursement designs and core business systems. Additionally, they will provide analysis of efficiencies related to system enhancement and automation, and review, analyze, and document system effectiveness and efficiency, developing strategies for improvement.
Requirements
- Bachelor’s degree in Computer Science, Electrical Engineering, Information Technology, related field, or foreign degree equivalent.
- 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.
Responsibilities
- 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.
Benefits
- Bonus tied to company and individual performance
- Substantial and comprehensive total rewards package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
