This position supports TRICARE Prime® Demo by CareSource Military & Veterans.
Responsible for reviewing and breaking down complex medical business requirements into configurable requirements.
Create and maintain benefit grids with annual and ad hoc changes.
Perform peer review of configuration templates and provide documentation of results.
Communicate effectively with various internal departments to enhance cross-functional awareness.
Participate in the annual benefit change process with Product Management and Benefit Analysts.
Create and utilize reports to analyze data to assist with issue resolution and impact analysis.
Adhere to defined SLAs while also accommodating urgent requests.
Provide guidance and mentorship to teammates/peers.
Manage the Quarterly Code Process across multiple teams for all LOB’s.
Requirements
Military affiliation or TRICARE experience is preferred.
Bachelor's degree in a related field or equivalent years of relevant work experience is required.
Minimum of five (5) years of medical benefit plan design and/or configuration experience is required.
Configuration experience (Facets or equivalent system) preferred.
Managed Care or healthcare experience is preferred.
Benefits
In addition to base compensation, you may qualify for a bonus tied to company and individual performance.
Comprehensive total rewards package.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical business requirementsbenefit gridsconfiguration templatesdata analysisissue resolutionimpact analysismedical benefit plan designconfiguration experienceFacetsmanaged care
Soft skills
communicationcross-functional awarenessguidancementorshippeer reviewcollaborationproblem-solvingadaptabilitytime managementattention to detail