Director, Claims Process Optimization ( Facets Required)

Education and Experience:

• Bachelor's degree in business, health administration, data analytics, or a related field required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Seven (7) years of health plan claims or healthcare operations experience is required
• Five (5) years of leadership experience is required
• Competencies, Knowledge and Skills:
• Practical understanding of automation and artificial intelligence capabilities applicable to claims work
• Working knowledge of claims adjudication platforms, provider reimbursement methodologies, and standard code sets including CPT, HCPCS, ICD-10, and revenue codes
• Strong analytical skills
• Proven change leadership skills
• Strong financial acumen
• Clear written and verbal communication, including the ability to present technical detail and operational risk to executive audiences
• Licensure and Certification:
• Working Conditions:
• General office environment; may be required to sit or stand for extended periods of time
• Travel is not typically required
• Compensation Range:
• $113,000.00 - $197,700.00
• 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 (hourly/salary):
• Salary
• Organization Level Competencies
• Fostering a Collaborative Workplace Culture
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business
• 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.
• Brand=CareSource

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.

Preferred Qualifications

• 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.