Deloitte Job - 31134450 | CareerArc
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Company: Deloitte
Location: Washington, DC
Career Level: Associate
Industries: Business Services, Consulting

Description




Manager Healthcare -\nPlan Configuration Specialist


Deloitte leads with purpose, solving complex issues for our\nclients and communities. Across disciplines and across borders, Deloitte Global\nsupports our network of member firms by developing and driving global strategy,\nprograms, and platforms, and creating new solutions and transformational\nexperiences. Our people share a passion for igniting change and a strong\nservice orientation that shapes our organization and those it supports.

\n\n

Are you an experienced professional with health plan and core\nadministration configuration experience? Do you have a penchant for detail,\nhave prior health insurance claim processing and leadership experience? Are you\neager to leverage your expertise to develop a team at Deloitte that supports\nplatform configuration and implementation efforts at health plans? Do you\nencourage creative and innovative thinking from team members while helping them\nto bring their ideas and career plans to fruition?

\n\n



Work you'll do


You will provide expertise to Deloitte clients using or\nimplementing core administration platforms (e.g., HealthRules, Facets) and\nguide them through the various configuration options available within the tool\nto meet their needs. In addition, you will lead the Deloitte team efforts for\ndefining processes, workflows, methods, tools, training, and expected outputs\nto support configuration best practices.

\n\n

    \n
  • Demonstrate expertise in core administration\n platforms and health plan functions to clients, especially around platform\n configuration and workflows
  • \n
  • Gather client requirements and develop clear\n configuration designs for clients based on their current business needs\n and their future business requirements
  • \n
  • Assist client with the implementation of\n configuration requirements, train client resources on maintenance and\n configuration support, and support go live activities
  • \n
  • Participate in quality assurance activities to\n promote traceability, accountability, and adherence to configuration\n standards and best practices in a multi-instance model
  • \n
  • Assist client with the identification,\n prioritization, coordination, and resolution of issues with various\n business areas and third-party vendors that impact production and quality\n of system implementation efforts
  • \n
  • Foster a trusting and safe environment with an\n emphasis on problem solving and continuous improvement
  • \n




What you'll be part of—our Deloitte Global culture:


At Deloitte, we expect results. Incredible—tangible—results. And\nDeloitte Global professionals play a unique role in delivering those results.\nWe reach across disciplines and borders to serve our global organization. We\nare the engine of Deloitte. We develop and lead global strategies and provide\nprograms and services that unite our network.

In Deloitte Global, everyone has an opportunity to lead. We see\nthe importance of your perspective and your ability to create value. We want\nyou to fit in—with an inclusive culture, focus on work-life fit and well-being,\nand a supportive, connected environment; but we also want you to stand out—with\nopportunities to have a strategic impact, innovate, and take the risks\nnecessary to make your mark.

Deloitte Global supports our talented professionals in answering\nthe question: What impact will you make?

\n\n



Who you'll work with:

\n\n

Deloitte leads with purpose, solving complex issues for our\nclients and communities. Across disciplines and across borders, Deloitte Global\nsupports our network of member firms by developing and driving global strategy,\nprograms, and platforms, and creating new solutions and transformational\nexperiences. Our people share a passion for igniting change and a strong\nservice orientation that shapes our organization and those it supports.

\n\n




How you'll grow:

\n\n

Deloitte Global inspires leaders at every level. We believe in\ninvesting in you, helping you embrace leadership opportunities at every step of\nyour career, and helping you identify and hone your unique strengths. We\nencourage you to grow by providing formal and informal development programs,\ncoaching and mentoring, and on-the-job challenges. We want you to ask\nquestions, take chances, and explore the possible.

\n\n



Benefits you'll receive:

\n\n

Deloitte's Total Rewards program reflects our continued commitment\nto lead from the front in everything we do — that's why we take pride in\noffering a comprehensive variety of programs and resources to support your\nhealth and well-being needs. We provide the benefits, competitive compensation,\nand recognition to help sustain your efforts in making an impact that matters.

\n\n



Required:

  • Experience\n with delivering large technology programs, establishing high performing\n teams, and selling client projects
  • \n
  • Demonstrated\n understanding of the health insurance business (Commercial [Employer and\n Individual], Medicare, Medicaid, Federal Employee Program, HealthCare\n Exchanges)
  • \n
  • Expertise\n in three or more of the following health plan functional areas: membership\n and enrollment, billing, claims and claim payables, products and benefits,\n provider services, provider networks, provider reimbursement\n methodologies, authorizations, utilization management, care management,\n customer service
  • \n
  • Understanding\n of the health care industry, including market landscape, regulatory\n environment, and industry trends
  • \n
  • Proficient\n in MS Office (PowerPoint, Excel, Word)
  • \n
  • Strong\n leadership and management skills
  • \n
  • Ability\n to provide strategic leadership and demonstrate the ability to develop\n future state scenarios, create a vision for the future, and define factors\n and key actions needed to achieve success
  • \n
  • Proven\n critical thinking and problem-solving skills on business and technical\n constructs
  • \n
  • Work\n effectively in cross functional team environment
  • \n
  • Proactive\n and open to learning new technologies
  • \n
  • Excellent\n written and verbal communication skills
  • \n
  • Strong\n work ethic; comfortable working in a fast-paced environment
  • \n
  • Ability\n to lead peers through influence and vision
  • \n
  • Executive-level\n communication skills
  • \n
  • No\n sponsorship
  • \n




Education and experience:

\n\n

  • Bachelor's\n degree in computer science or relevant field from an accredited college or\n university
  • \n
  • 5+\n years of relevant professional experience in a large, diverse, multi-location\n environment
  • \n
  • 5+\n years' experience within the health care industry, specifically focused on\n health insurance core administration functions and platforms
  • \n
  • Experience\n with large ($40M+) technology program management and developing high\n impact teams to deliver complex projects
  • \n
  • Extensive\n experience in health insurance claims processing and system configuration\n with a minimum of 3-5 years' experience
  • \n
  • SDLC\n (system development life cycle) management experience in waterfall, agile,\n and/or scaled agile
  • \n
  • Experience\n in one of the following types of projects in health plans: core\n administration platform configuration, core administration migration,\n operational and IT solution design, operational and IT impact assessments,\n system evaluation and selection, or application rationalization
  • \n
  • Experience\n building and overseeing a team, including training resources, establishing\n and sharing best practices, and managing resources across multiple\n projects
  • \n

\n\n



Additional desired\nskills (optional):

\n\n

    \n
  • HealthEdge HealthRules Payor experience
  • \n
  • Facets / QNXT experience
  • \n
  • Oracle Health Insurance Solutions experience
  • \n
  • Epic Tapestry experience
  • \n
  • Provider data migration experience
  • \n
  • Health plan configuration experience
  • \n
  • Master's degree from an accredited college or\n university
  • \n

\n\n



Example of a project assignment:

\n\n

    \n
  • Lead benefits / products, provider,\n contracting, and other configuration efforts
  • \n
  • Provider demographic and pricing set up to\n support platform migration
  • \n
  • Build out and roll out of product build\n out/configuration in support of membership migration
  • \n
  • HealthEdge configuration lead
  • \n

\n\n



How you'll grow:

\n\n

Deloitte Global inspires leaders at every level. We believe in\ninvesting in you, helping you embrace leadership opportunities at every step of\nyour career, and helping you identify and hone your unique strengths. We\nencourage you to grow by providing formal and informal development programs,\ncoaching and mentoring, and on-the-job challenges. We want you to ask\nquestions, take chances, and explore the possible.

\n\n



Benefits you'll receive:

\n\n

Deloitte's Total Rewards program reflects our continued commitment\nto lead from the front in everything we do — that's why we take pride in\noffering a comprehensive variety of programs and resources to support your\nhealth and well-being needs. We provide the benefits, competitive compensation,\nand recognition to help sustain your efforts in making an impact that matters.

\n\n



Required:

    \n
  • Experience\n with delivering large technology programs, establishing high performing\n teams, and selling client projects
  • \n
  • Demonstrated\n understanding of the health insurance business (Commercial [Employer and\n Individual], Medicare, Medicaid, Federal Employee Program, HealthCare\n Exchanges)
  • \n
  • Expertise\n in three or more of the following health plan functional areas: membership\n and enrollment, billing, claims and claim payables, products and benefits,\n provider services, provider networks, provider reimbursement\n methodologies, authorizations, utilization management, care management,\n customer service
  • \n
  • Understanding\n of the health care industry, including market landscape, regulatory\n environment, and industry trends
  • \n
  • Proficient\n in MS Office (PowerPoint, Excel, Word)
  • \n
  • Strong\n leadership and management skills
  • \n
  • Ability\n to provide strategic leadership and demonstrate the ability to develop\n future state scenarios, create a vision for the future, and define factors\n and key actions needed to achieve success
  • \n
  • Proven\n critical thinking and problem-solving skills on business and technical\n constructs
  • \n
  • Work\n effectively in cross functional team environment
  • \n
  • Proactive\n and open to learning new technologies
  • \n
  • Excellent\n written and verbal communication skills
  • \n
  • Strong\n work ethic; comfortable working in a fast-paced environment
  • \n
  • Ability\n to lead peers through influence and vision
  • \n
  • Executive-level\n communication skills
  • \n
  • No\n sponsorship
  • \n

\n\n



Education and experience:

    \n
  • Bachelor's\n degree in computer science or relevant field from an accredited college or\n university
  • \n
  • 5+\n years of relevant professional experience in a large, diverse,\n multi-location environment
  • \n
  • 5+\n years' experience within the health care industry, specifically focused on\n health insurance core administration functions and platforms
  • \n
  • Experience\n with large ($40M+) technology program management and developing high\n impact teams to deliver complex projects
  • \n
  • Extensive\n experience in health insurance claims processing and system configuration\n with a minimum of 3-5 years' experience
  • \n
  • SDLC\n (system development life cycle) management experience in waterfall, agile,\n and/or scaled agile
  • \n
  • Experience\n in one of the following types of projects in health plans: core\n administration platform configuration, core administration migration,\n operational and IT solution design, operational and IT impact assessments,\n system evaluation and selection, or application rationalization
  • \n
  • Experience\n building and overseeing a team, including training resources, establishing\n and sharing best practices, and managing resources across multiple\n projects
  • \n




Additional desired skills\n(optional):

    \n
  • HealthEdge HealthRules Payor experience
  • \n
  • Facets / QNXT experience
  • \n
  • Oracle Health Insurance Solutions experience
  • \n
  • Epic Tapestry experience
  • \n
  • Provider data migration experience
  • \n
  • Health plan configuration experience
  • \n
  • Master's degree from an accredited college or\n university
  • \n




Example of a project assignment:

    \n
  • Lead benefits / products, provider,\n contracting, and other configuration efforts
  • \n
  • Provider demographic and pricing set up to\n support platform migration
  • \n
  • Build out and roll out of product build out/configuration\n in support of membership migration
  • \n
  • HealthEdge configuration lead




How you'll grow

At Deloitte, our\nprofessional development plan focuses on helping people at every level of their\ncareer to identify and use their strengths to do their best work every day.\nFrom entry-level employees to senior leaders, we believe there's always room to\nlearn. We offer opportunities to help sharpen skills in addition to hands-on\nexperience in the global, fast-changing business world. From on-the-job\nlearning experiences to formal development programs at Deloitte University, our\nprofessionals have a variety of opportunities to continue to grow throughout\ntheir career. Explore Deloitte University, The Leadership Center.

\n\n



Benefits



At Deloitte, we know\nthat great people make a great organization. We value our people and offer\nemployees a broad range of benefits. Learn more about what working at Deloitte can mean for you.

\n\n



Deloitte's culture


Our positive and\nsupportive culture encourages our people to do their best work every day. We\ncelebrate individuals by recognizing their uniqueness and offering them the\nflexibility to make daily choices that can help them to be healthy, centered,\nconfident, and aware. We offer well-being programs and are continuously looking\nfor new ways to maintain a culture where our people excel and lead healthy,\nhappy lives. Learn more about Life at Deloitte.




Corporate citizenship

Deloitte is led by a\npurpose: to make an impact that matters. This purpose defines who we are and\nextends to relationships with our clients, our people and our\ncommunities. We believe that business has the power to inspire and\ntransform. We focus on education, giving, skill-based volunteerism, and leadership\nto help drive positive social impact in our communities. Learn more about Deloitte's impact on the world.

\n\n



Recruiter tips

We want job seekers\nexploring opportunities at Deloitte to feel prepared and confident. To help you\nwith your interview, we suggest that you do your research: know some background\nabout the organization and the business area you're applying to. Check out recruiting tips from Deloitte professionals.

\n\n

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As used in this posting, “Deloitte” means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.

Deloitte will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws. See notices of various ban-the-box laws where available. https://www2.deloitte.com/us/en/pages/careers/articles/ban-the-box-notices.html



Requisition code: E20NATCMGRSF200-CBO


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