Team Lead, Member Benefits (Benefits/Config Experience Required)

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:
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.

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