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Manager, Operations Configuration

Charlotte, North Carolina Apply Now Job ID 1145124 Category Health Insurance Operations Organization Carolina Complete Health Schedule Full-time
Description:
Position Purpose: The Manager of Operations Configuration is responsible for design, testing, implementation and maintenance of benefit and pricing configuration tables, edits, files, programs and software to achieve accurate claims adjudication in a multiple product, multiple state, managed care environment.

  • Manages the configuration/Integration team in all aspects of design, configuration, testing, documentation and implementation of new projects, products, benefit plans, provider contracts, etc. to ensure that software solutions successfully meet the business strategies and contractual requirements.
  • Manages the development of requirements, cost/benefit analysis, detailed design specifications, project status reports, issue logs and resource planning for all assigned projects.
  • Ensures that best practices and best techniques are utilized during the life cycle stages of project management and system testing. This includes but not limited to business owner involvement, prioritization, business owner sign off, project status reporting, etc.
  • Proactively identifies opportunities to continually improve the application/configuration performance to support business requirements both efficiently and effectively.
  • Manages a work team, overseeing individual assignments, empowering team members to make decisions while creating a motivating team environment. Ensures that all Health net policies and procedures are adhered to including, but not limited to, Health Net confidentiality policy.
  • Implements and maintains a quality assurance methodology to ensure accurate and timely delivery of all configuration projects that are released into the production environment.
  • Implements and maintains a training program for all new Configuration/Integration team members.
  • Qualifications:

    Education/Experience: Bachelor’s Degree or an equivalent combination of education and experience in a managed care environment. Eight to ten years experience in a managed care environment, with multiple product offerings desired. Demonstrated management experience with minimum six to eight years experience in progressive claim processing and/or software configuration desired


    License/Certification:

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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