Benefit Support Analyst III (Config experience required)

Job Summary :

This position supports TRICARE Prime Demo by CareSource Military & Veterans, which aims to enhance healthcare access and prioritize the unique needs of the military community. We encourage military affiliated individuals, veterans, military spouses, and those with prior TRICARE experience to apply.

The Benefit Support Analyst III is responsible for reviewing and breaking down complex medical business requirements into configurable requirements and working with configuration and other partners in helping to develop the strategic direction of member benefits across all states and product lines.

Essential Functions :

• Create and maintain benefit grids with annual and ad hoc changes
• Create, maintain, review, and analyze configuration templates to validate benefit requirements and regulations are accurate; collaborate with policy and markets to confirm and resolve conflicts
• Perform peer review of configuration templates and provide documentation of results within the defined SLA guidelines; identify and implement opportunities for process improvement
• Communicate effectively with various internal departments to enhance cross-functional awareness, promote process improvement, and identify root cause resolution of issues
• Participate in the annual benefit change process with Product Management and Benefit Analysts as appropriate per market
• Create and utilize reports to analyze data to assist with issue resolution and impact analysis
• Adhere to defined SLAs while also accommodating urgent requests
• Incorporate critical thinking skills, discretion, and independent judgement into the analysis process to determine the best course of action for each issue / task
• Create and maintain SOPs and supporting process flows
• Provide guidance and mentorship to teammates / peers
• Update and maintain the data management tool
• Lead and facilitate cross functional or project meetings as assigned
• Assist in the training and development of new hires and continuous training for peers
• Manage the Quarterly Code Process across multiple teams for all LOB's
• Lead and / or participate in projects as assigned
• Act as Back up to Team Lead, Triage Analyst and all BA functions as needed
• Perform any other job-related instructions as requested

Education and Experience :

Military affiliation or TRICARE experience is preferred.

Bachelor's degree in a related field or equivalent years of relevant work experience is required

Competencies, Knowledge and Skills :

Licensure and Certification :

Working Conditions :

Compensation Range :

$70,800.00 - $113,200.00 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. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type : Salary

Competencies :

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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