Job Summary

We are seeking a dedicated and experienced Director of Core Systems Strategies to lead our configuration team, ensuring accurate and timely implementation of critical information on claims databases. This role is essential in maintaining adherence to health plan business and system requirements, particularly in areas such as contracting, benefits, prior authorizations, and fee schedules.

Responsibilities

• Direct and oversee the configuration team, ensuring accountability for performance and meeting established targets based on health plan and regulatory requirements.
• Strategically plan and manage configuration workflow processes to optimize efficiency and effectiveness.
• Continuously identify opportunities for operational improvements and implement best practices within assigned operational areas.
• Ensure that appropriate resources are available to meet department goals and effectively communicate any resource needs or deficiencies to leadership.
• Identify and implement strategic process improvements related to configuration functions to enhance service delivery and compliance.
• Collaborate with cross-functional teams to support business objectives and ensure alignment with company goals.

Requirements

• Bachelor's degree in a relevant field; Master's degree preferred.
• Minimum of 7 years of experience in a healthcare operations or systems management role.
• Proven track record of managing teams and achieving performance targets in a healthcare setting.
• Strong analytical and problem-solving skills, with the ability to make data-driven decisions.
• Excellent communication and interpersonal skills, with the ability to work collaboratively across departments.
• Familiarity with QNXT and NetworX systems is a plus.

Benefits

• Competitive salary and performance-based bonuses.
• Comprehensive health, dental, and vision insurance plans.
• Generous paid time off and holiday schedule.
• Retirement savings plan with company match.
• Opportunities for professional development and advancement within the organization.