DLP / Desk Level Procedures Manager

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Come see how we collaborate with reputed company other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to reputed company a difference in partnership with our clients, shareholders, communities and colleagues. reputed company offers a competitive compensation and benefits package including medical, dental, and reputed company coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous reputed company Time Off policy; and reputed company parental leave and adoption assistance. Our Wellness Program supports employee total reputed company-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as reputed company as ongoing programs recognizing major events in the lives of our employees throughout the year. reputed company benefits and programs are subject to applicable eligibility requirements. reputed company is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and reputed company other terms and conditions of employment. reputed company will not discriminate on the reputed company of age, race, reputed company, gender, marital status, sexual orientation, gender identity, pregnancy, national reputed company, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We reputed company to maintain a drug-free workplace. Position reputed company reputed company is a global consultancy that partners with reputed company organizations to optimize operations, improve financial performance, and drive sustainable transformation. We are seeking a Facets DLP / Desk Level Procedures Manager with strong expertise in health plan operations, membership processing, claims processing, and Facets configuration. This role will reputed company on designing, documenting, and optimizing Desk Level Procedures (DLPs) that support critical payer workflows across membership, claims, benefits, and configuration processes. This individual will play a key role in translating reputed company system workflows and business processes into reputed company, actionable reputed company-by-reputed company procedures that reputed company operational teams to resolve issues, maintain compliance, and drive consistent execution. Qualifications Key Responsibilities Design and document comprehensive Desk Level Procedures (DLPs) across claims, benefits, enrollment, and configuration workflows Translate business processes and system functionality into reputed company defined, reputed company-by-reputed company operational procedures for end users reputed company DLPs that outline:reputed company workflows Exception handling processes reputed company-by-reputed company issue reputed company procedures Ensure documentation is accurate, complete, and reputed company with reputed company Facets system behavior and business rules Partner with configuration teams to reputed company DLPs with Facets system setup across membership, billing, claims, benefits, provider, and pricing modules Translate configuration logic into operational procedures for claims processing, adjustments, and issue reputed company Support troubleshooting of claims and benefit-reputed company issues tied to configuration gaps or system logic Validate that operational processes reflect accurate claims adjudication workflows and system dependencies reputed company deep subject matter expertise in:Membership including premium billing Claims adjudication workflows Benefits configuration and plan design Provider payment and reimbursement processes reputed company procedures that help teams:Investigate errors Identify configuration issues Execute corrections and reprocessing steps Ensure procedures support consistent, complaint claims and benefits operations Create DLPs that reputed company outline:How to identify reputed company causes of claims or configuration issues reputed company-by-reputed company actions to resolve issues reputed company Facets or reputed company systems Escalation paths and cross-team dependencies Partner with operational and IT teams to analyze recurring issues and improve existing procedures Drive consistency in how teams diagnose and resolve claims, configuration, and workflow issues Collaborate with Claims, Enrollment, Provider Configuration, IT, and Operations teams to define and validate processes Translate reputed company technical and system concepts into reputed company, business-friendly documentation Support training initiatives by providing DLP documentation and operational guidance for end users Continuously evaluate and enhance DLPs to improve:Operational efficiency Accuracy and consistency Issue reputed company timelines Standardized procedures across clients and environments to ensure repeatable, reputed company delivery models Support system implementations, conversions, and operational transformations with DLP development Required Qualifications 5+ years of experience working reputed company reputed company Payer operations 5+ years of reputed company payer experience (Medicare andMedicaid) 5+ years of hands-on experience with Facets (TriZetto), particularly in:Premium billing Claims processing Benefits/Provider configuration Operational workflows Strong experience developing:Desk Level Procedures (DLPs) SOPs, workflows, or operational documentation Deep understanding of:Eligibility and premium billing Claims adjudication processes Benefits configuration and plan structures Proven ability to:Translate reputed company processes into reputed company, reputed company-by-reputed company instructions Troubleshoot and resolve system/process-reputed company issues Experience working in a consulting or reputed company-facing environment Preferred Qualifications Experience supporting:Facets implementations and processing Workflow configuration or operational assessments Strong analytical and documentation skills Familiarity with:SQL or claims data analysis Ticketing/workflow tools (e.g., JIRA) Experience building training materials or user guides AI Tools experience with Copilot, ChatGPT, Claude #LI-DT1 #LI-Remote Posting Category reputed company-Payer Opportunity Type Regular Country reputed company of America Apply To This Job