REMOTE - Director, Clinical Systems Configuration(Guiding Care Experience Preferred) - R7796
REMOTE - Director, Clinical Systems Configuration(Guiding Care Experience Preferred) - R7796
CareSource
United States
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The Director, Clinical Systems Configuration leads the analysis, design, development, testing and implementation of the company’s Guiding Care platform and provides application support during advanced stages of implementation.
Essential Functions
- Direct and lead configuration activities of a highly technical team by providing coaching and mentoring with a focus on quality, efficiency and collaboration; provide guidance in resolving technical issues
- Direct database configuration activities intended to modify and enhance the company operational database; activities include database set-up to support Prior Authorization , Care Management and Clinical team needs
- Lead automation and upgradation efforts for Guiding Care platform
- Responsible for proactive analysis of internal operational, service and performance metrics, and proactively initiate performance improvement activities across the organization to achieve service and satisfaction goals
- Create technical design and provide technical oversight to ensure the proper architecture and product performance is delivered; create architectural design and technical design documents
- Ensure appropriate approvals, testing, implementation controls and validation occur relative to new or modified records and files
- Develop and maintain departmental policies, procedures and controls to ensure the integrity of the files, including HIPAA compliance
- Initiate and implement automated solutions to ensure optimal data quality
- Ensure that all policies and procedures are in place, are up to date, are consistent across department and CareSource and are compliant with all legal, Federal, State and Accrediting standards
- Ensure compliance with Model Audit Rules, State, Federal and Accrediting Agencies for all elements related to systems configuration data and processes
- Participate in national conferences and other events to stay current with industry changes
- Provide direction in the development of best practices configuration strategies to meet corporate goals related to operational efficiencies and excellence
- Work with business owners to achieve a system design that meets their needs and expectations
- Ensure that supporting business processes and documentation exists as a basis for system logic
- Play a consultative role with business owners around configuration and items related to Clinical operations
- Perform any other job related instructions as requested
- Bachelor’s degree or equivalent years of relevant work experience is required
- Master’s degree is preferred
- Minimum of five (5) years of health plan business or systems solutions experience is required
- Minimum of three (3) years of management experience is required
- Guiding Care experience is required
- Facets experience preferred
- Proficient in Microsoft Office Suite to include Word, Excel, Access and Outlook
- Familiarity of the healthcare field
- High level of database and systems development knowledge
- Ability to translate business requirements into technical specifications
- Ability to manage and prioritize multiple tasks, promote teamwork and fact based decision
- Strong team and staff development skills
- Strong collaboration and conflict resolution skill sets
- Proven leadership with the ability to build relationships, collaborate and influence at all levels
- Strong process and analytical skills with the ability to articulate and define outcome measures that capture key performance metrics
- Strategic management skills
- Resiliency in a changing environment
- Strong decision making and problem solving skills
- Exceptional written and verbal communication skills with the ability to present information in a variety of different formats to all levels
- Strong interpersonal skills and high level of professionalism
- Effective listening and critical thinking skills
- Ability to develop, prioritize and accomplish goals
- Excellent problem solving skills with attention to detail
- Six Sigma certificate or training preferred
- General office environment; may be required to sit/stand for long periods of time
- Ability to travel as required by the needs of the business
$108,600.00 - $190,000.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
Competencies
- Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
-
Seniority level
Director -
Employment type
Full-time -
Job function
Other -
Industries
Insurance
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