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CareSource · 1 day ago

REMOTE - Configuration Analyst III (Must have Facets and Automation experience) - R11100

United States

Full-time

Remote

Mid, Senior Level

$83K/yr - $133K/yr

5+ years exp

CareSource is a healthcare company seeking a Configuration Systems Analyst III responsible for managing and defining system configuration requirements. The role involves analyzing data, managing issues, and leading configuration initiatives to enhance system efficiency and support operational needs.

Health CareMedicalNon Profit

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

Manage and define system configuration requirements. Responsibility for requirements, definition, document, design, testing, training and implementation support using appropriate templates or analysis tool

Develop and utilize reports to analyze and stratify data in order to address gaps and provide answers to issues identified within the department or by other departments

Identify, manage and document the status of open issues, configuration design, and final resolution within change management system

Review and interpret regulatory items, timely delivery of required updates

Development of standard code set and reimbursement design templates

Plan and implement new software releases including testing and training

Participate in meetings with business owners, users and IT to achieve solutions that meet the requirements and expectation of CareSource Lead configuration initiatives in payment policy meetings and present to committees

Coordinate annual benefit changes with internal resources

Provide analysis of efficiencies related to system enhancement and automation. Review, analyze, and document effectiveness and efficiency of existing systems and develop strategies for improving or further leveraging systems

Manage the reimbursement review. Identify and design appropriate changes. Lead the development and execution of test plans and scenarios for all reimbursement designs for core business system and related processes

Audit configuration to ensure accuracy and internal controls to minimize fraud and abuse and overpayment related issues

Anticipate and identify customer needs and match products and services to facilitate the fulfillment of those needs

Ensure system processes and documents exist as basis for system logic

Manage resources and communications to facilitate work completion

Mentor the use of tools to define requirements

Perform any other job duties as requested

Qualification

FacetsConfiguration experienceHealth plan experienceVBASQLPythonC++Microsoft SuiteMedical codingCustomer serviceVendor managementEffective listeningCritical thinkingProblem solvingWritten communicationVerbal communicationInterpersonal skillsTeamworkAttention to detail

Required

High School Diploma or GED is required

A minimum of five (5) years of health plan experience, to include three (3) years of configuration or clinical editing software experience is required

Exceptional computer skills and abilities in Facets

Proven understanding of database relationships required

Effective listening and critical thinking skills

Effective problem solving skills with attention to detail

Excellent written and verbal communication skills

Ability to work independently and within a team environment

Strong interpersonal skills and high level of professionalism

Ability to develop, prioritize and accomplish goals

Understanding of the healthcare field and knowledge of Medicaid and Medicare

Proper medical coding knowledge and claims processing skills

Customer service oriented

Ability to manage vendor relationships

Preferred

Bachelor's degree or equivalent years of relevant work experience is preferred

Exposure to Facets or equivalent system is preferred

Knowledge of coding languages (e.g. VBA, SQL, Python, C++, etc.)

Advanced proficiency Microsoft Suite to include Word, Excel, Access and Visio

Understanding of DRG and APC reimbursement methods

Understanding of CPT, HCPCs and ICD-CM Codes

Knowledge of HIPAA Transaction Codes

Facets knowledge/training

Certified Medical Coder (CPC) is preferred

Benefits

You may qualify for a bonus tied to company and individual performance.

A substantial and comprehensive total rewards package.

Company

CareSource

Glassdoor3.8

CareSource provides managed care services to Medicaid beneficiaries.

Founded in 1989

Dayton, Ohio, USA

1001-5000 employees

https://www.caresource.com/

H1B Sponsorship

CareSource has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (30)

2024 (39)

2023 (35)

2022 (21)

2021 (37)

2020 (28)