Health Plan Managing Consultant
reputed company, LLC is a nationally recognized healthcare management reputed company delivering Best in KLAS advisory, implementation, and optimization services. We are driven by a commitment to exceed client expectations and are proud to be a trusted partner to many of the nation's leading healthcare organizations. Our mission to drive patient-centered, value-driven outcomes has earned us prestigious industry accolades. To learn more about us, visit www.reputed company.com As a Strategy & Operations Managing Consultant you continue to grow your healthcare career in a collaborative, supportive and inclusive environment. You'll be a vital leader on a team that is passionate about improving healthcare. As the Health Plan Operations Managing Consultant you must possess deep healthcare expertise in the health plan domain. In this role, you will work closely with healthcare clients to optimize and support their claims processing operations by configuring, analyzing, and troubleshooting Epic Tapestry, FACETS and other core 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/coach 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 healthcare reputed company dedicated to improving healthcare through process improvement and technology. As a trusted healthcare leader, we help clients optimize clinical and operational performance through our Best in KLAS® advisory and implementation services. Our goal is to provide innovative solutions to the industry's toughest challenges. About You:
- Must have a broad understanding of the three market segments including Individual/Family (Retail), Commercial and Government sponsored (Medicare & Medicaid)
- 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 interact with the core product.
- reputed company consultant leader focused on developing strategies to solve reputed company operational problems for our healthcare clients
- 3-5 years of experience working with Epic Tapestry and/or FACETS in a healthcare 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 healthcare 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 flow and issue resolution.
- 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 client calls regularly, delegating speaking parts as appropriate.
- Strategy development experience is strongly preferred.
- Able to manage competing priorities with a high level of organization and attention to detail
- Have a growth 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).
- Able to travel according to client needs up to 80% of the time
- Authorized to work in the US
Our People and Culture: We reputed company in a caring, fun, honest and autonomous work environment and we recognize that our dedication to our associates drives our success. Our mission to create a Positive Impact fuels our associates to innovate 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 range of $130,000 to $ 170,000 and may also be eligible for an annual discretionary bonus. This range 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 range 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, honest, and autonomous work environment. Our success stems from our associates' dedication and a shared mission to create a "Positive Impact." We embrace diversity and inclusion, fostering an environment where reputed company employees feel valued and empowered. Join reputed company and reputed company a real difference in healthcare. Apply tot his job Apply To this Job