Our System Liaison (Care Management) will contribute to the achievement of corporate and team objectives by managing and controlling the operational processes for all Care Management operational systems. This will include the support all platform solutions, leading system conversions and upgrades, monitoring and maintaining integrity of the system infrastructure, and acting as a resource for technical and user requirements. Additionally, this individual will act as subject matter expert for all platforms and solutions for internal and external stakeholders.
- Accountability: Owning and taking responsibility for one’s actions.
- Business Acumen: Understanding industry, market, financial and company specific operations.
- Collaboration and Communication: Working together; listen to other’s ideas; communicate accurately and concisely.
- Decision Making: Consider all facts and impacts when making decisions.
- Focus on the Customer: Consistently doing what is in the best interest of our customer. Leaving a positive impression on the customer by elevating their experience; making it simpler and educating to helping them understand.
Minimum Qualifications Required (all must be met to be considered):
- Bachelor's degree or direct and applicable work experience.
- 4+ years of experience managing enterprise-wide claims processing business systems (e.g., Facets), applications, or platforms with at least 2+ years of experience as a System Specialist – Care Management OR previous experience that combines related technical expertise with knowledge of operational business processes.
- Prior consulting experience with effective relationship management skills. Ability to provide recommendations to key decision makers and influence business decisions.
- Demonstrated problem solving and critical thinking skills with a continuous process improvement focus.
- Strong written and verbal communication skills with the ability to effectively communicate complex/technical information to varying audiences.
- Proactive self-starter with effective time management skills and the ability to independently organize competing priorities and tasks. Strong attention to detail.
- Proficiency with the Microsoft Office suite. Technical aptitude to learn new programs quickly.
Hiring Specifications Preferred:
- Facets experience.
- Experience supporting a vendor solution.
a. Manage and control the operational processes for all Care Management operational systems. Analyze the operational processes to provide support for internal and external customers regarding system and integration issues and make recommendations to minimize errors and reduce manual interventions in the process.
b. Define, analyze, plan, test, implement, maintain and document technology solutions for multiple applications and systems that satisfy business objectives. Communicate in a timely manner and recommend file and/or system changes to minimize errors.
c. Daily oversight and relationship management with vendor contacts. Ensure accurate system integrations, adherence to Service Level Agreements, assurance of regulatory compliance and invoicing/reconciliations.
d. Manage multiple project initiatives with responsibility at different levels. Responsible for building lookup tables, interfacing with stakeholders across Wellmark, and oversight for completion of tasks/goals completed by and with others.
e. Collaborate with Wellmark business stakeholders for group accounts and vendors to ensure accurate processing of all systems integrations and reporting.
f. Provide training and education to internal/external stakeholders. Serve as the Subject Matter Expert for technical and user requirements for processing.
g. Demonstrate business knowledge for determining business requirements for the design of operational system upgrades and enhancements. Participate in system conversions and lead various upgrade components.
h. Coach and mentor team leaders with understanding system capabilities as they develop staff productivity and caseload reports.
i. Comply with regulatory standards, accreditation standards and internal guidelines remain current and consistent with the standards pertinent to the Care Management Operations team.
j. Other duties as assigned.
Job ID 212543