AmeriHealth Caritas Supervisor Configuration Auditing in Philadelphia, Pennsylvania

Supervisor Configuration Auditing


Description

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Coordinate actions with the Service teams and the facets configuration team to improve overall accuracy and quality of facets configuration. The supervisor would lead and support the configuration auditors as they review all facets configuration changes and documentation associated with such changes for accuracy and completeness. He/she will monitor and track the workflow between the configuration and auditing team taking steps to highlight and change any inefficiencies and address issues. The supervisor will be responsible for meeting expected turnaround times and SLAs associated with facets changes migrating into production. He/she will be responsible for working with the facets configuration team to develop, review and report out auditing results, trends and recommendations for improvements. He/she will also be responsible for overseeing the post implementation review process to ensure that all facets configuration changes are operating appropriately in the production environment. He/she will need to demonstrate creativity as we work to develop a “best in class” configuration QA program and continue to meet all required SLAs within the department. The supervisor will be tasked with identifying key contributors on the team and working with them to assist in their continued professional development.

Education/Experience:

  • Bachelor’s Degree preferred.
  • 3-5 years' configuration or related background
  • Microsoft Access for reporting, development and analysis.
  • 5-10 year's claims experience experience.
  • Facets claim processing knowledge required.
  • Computer proficiency in Microsoft Word, PowerPoint, Excel and all aspects of Access including table, query, form, macro and report development.
  • Supervisory experience preferred.
  • Auditing experience preferred.