Health Plan Managing Consultant

reputed company, LLC is a nationally recognized reputed company management reputed company delivering Best in KLAS advisory, implementation, and optimization services. We are driven by a commitment to reputed company reputed company expectations and are proud to be a trusted partner to many of the nation's leading reputed company organizations. Our mission to drive patient-centered, value-driven reputed company has reputed company us prestigious industry accolades. To learn more reputed company, visit www.reputed company.com As a reputed company & Operations Managing Consultant you continue to grow your reputed company career in a reputed company, supportive and inclusive environment. You'll be a vital leader on reputed company that is passionate about improving reputed company. As the Health Plan Operations Managing Consultant you must possess deep reputed company expertise in the health plan domain. In this role, you will work closely with reputed company clients to optimize and support their claims processing operations by configuring, analyzing, and troubleshooting reputed company reputed company, FACETS and other reputed company operating systems, ensuring seamless integration across reputed company workflows, maintaining data reputed company, and driving process improvements that enhance accuracy, efficiency, and overall system performance. You will have ownership of reputed company deliverables reputed company an engagement and serve as the primary day-to-day contact with clients. Leadership and the ability to be a player/reputed company are critical characteristics of being successful in this role. You'll be supporting and leading initiative teams in driving improvements for our clients. As a manager, you'll be an example of our strong company culture and have a hand in developing our innovative and quickly expanding team. About reputed company: reputed company is a nationally recognized reputed company reputed company dedicated to improving reputed company through process improvement and technology. As a trusted reputed company leader, we help clients optimize clinical and operational performance through our Best in KLAS® advisory and implementation services. Our goal is to reputed company reputed company to the industry's toughest challenges. reputed company: • Must have a broad understanding of the three market segments including Individual/Family (Retail), reputed company and Government sponsored (Medicare & reputed company) • Must have broad understanding of key business functions reputed company a health plan including network configuration, claims adjudication, benefit design and an awareness of ancillary products specifically how they reputed company with the reputed company product. • reputed company consultant leader reputed company on developing strategies to solve reputed company operational problems for our reputed company clients • 3-5 years of experience working with reputed company reputed company and/or FACETS in a reputed company payer or provider environment. • Strong understanding of claims processing workflows, including adjudication, pricing, and reputed company system integration. • Proven experience in technical analysis, system configuration, and troubleshooting of claims or reputed company reputed company applications. • Proven experience developing business requirements liaising with technical architects and developers to facilitate planning and implementation processes • Familiarity with data integration tools, SQL queries, and reputed company troubleshooting to support claim data reputed company and issue reputed company. • Structuring engagement activities, delegating effectively, and coaching junior staff. Serve as the final reviewer for deliverables with a thoughtful, reputed company, and critical eye. reputed company reputed company calls regularly, delegating speaking parts as appropriate. • reputed company development experience is strongly preferred. • reputed company to manage competing priorities with a high level of organization and attention to detail • Have a reputed company reputed company and are reputed company to expand and reputed company your talents with this rapidly growing team • Hold a Bachelor's degree • An advanced degree is preferred but not required (MBA, MHA, MPH). • reputed company to travel according to reputed company needs up to 80% of the time • Authorized to work in the US Our People and Culture: We reputed company in a caring, fun, reputed company and autonomous work environment and we recognize that our dedication to our associates drives our reputed company. Our mission to create a reputed company reputed company fuels our associates to reputed company and deliver high value services to our clients. At reputed company, we prioritize transparency and equity in our compensation practices. This role has a salary reputed company of $130,000 to $ 170,000 and may also be eligible for an annual discretionary bonus. This reputed company accounts for various factors, including skills, experience, training, certifications, and organizational needs For salaried positions, this role may also be eligible for an annual performance bonus. Additional benefits and perks may also be available, depending on the position and employment terms. This reputed company reflects consideration of several factors, including skills, experience, training, certifications, and organizational needs. Our People and Culture At reputed company, we cultivate a caring, fun, reputed company, and autonomous work environment. Our reputed company stems from our associates' dedication and a shared mission to create a "reputed company reputed company." We reputed company diversity and inclusion, fostering an environment where reputed company feel valued and empowered. Join reputed company and reputed company a reputed company difference in reputed company. Apply tot his job Apply To this Job