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Deloitte Manager Healthcare - Plan Configuration Specialist in Chicago, Illinois

Manager Healthcare -Plan Configuration Specialist

Deloitte leads with purpose, solving complex issues for ourclients and communities. Across disciplines and across borders, Deloitte Globalsupports our network of member firms by developing and driving global strategy,programs, and platforms, and creating new solutions and transformationalexperiences. Our people share a passion for igniting change and a strongservice orientation that shapes our organization and those it supports.

Are you an experienced professional with health plan and coreadministration configuration experience? Do you have a penchant for detail,have prior health insurance claim processing and leadership experience? Are youeager to leverage your expertise to develop a team at Deloitte that supportsplatform configuration and implementation efforts at health plans? Do youencourage creative and innovative thinking from team members while helping themto bring their ideas and career plans to fruition?

Work you ll do

You will provide expertise to Deloitte clients using orimplementing core administration platforms (e.g., HealthRules, Facets) andguide them through the various configuration options available within the toolto meet their needs. In addition, you will lead the Deloitte team efforts fordefining processes, workflows, methods, tools, training, and expected outputsto support configuration best practices.

  • Demonstrate expertise in core administration platforms and health plan functions to clients, especially around platform configuration and workflows

  • Gather client requirements and develop clear configuration designs for clients based on their current business needs and their future business requirements

  • Assist client with the implementation of configuration requirements, train client resources on maintenance and configuration support, and support go live activities

  • Participate in quality assurance activities to promote traceability, accountability, and adherence to configuration standards and best practices in a multi-instance model

  • Assist client with the identification, prioritization, coordination, and resolution of issues with various business areas and third-party vendors that impact production and quality of system implementation efforts

  • Foster a trusting and safe environment with an emphasis on problem solving and continuous improvement

What you ll be part ofour Deloitte Global culture:

At Deloitte, we expect results. Incredibletangibleresults. AndDeloitte Global professionals play a unique role in delivering those results.We reach across disciplines and borders to serve our global organization. Weare the engine of Deloitte. We develop and lead global strategies and provideprograms and services that unite our network.

In Deloitte Global, everyone has an opportunity to lead. We seethe importance of your perspective and your ability to create value. We wantyou to fit inwith an inclusive culture, focus on work-life fit and well-being,and a supportive, connected environment; but we also want you to stand outwithopportunities to have a strategic impact, innovate, and take the risksnecessary to make your mark.

Deloitte Global supports our talented professionals in answeringthe question: What impact will you make?

Who you ll work with:

Deloitte leads with purpose, solving complex issues for ourclients and communities. Across disciplines and across borders, Deloitte Globalsupports our network of member firms by developing and driving global strategy,programs, and platforms, and creating new solutions and transformationalexperiences. Our people share a passion for igniting change and a strongservice orientation that shapes our organization and those it supports.

How you ll grow:

Deloitte Global inspires leaders at every level. We believe ininvesting in you, helping you embrace leadership opportunities at every step ofyour career, and helping you identify and hone your unique strengths. Weencourage you to grow by providing formal and informal development programs,coaching and mentoring, and on-the-job challenges. We want you to askquestions, take chances, and explore the possible.

Benefits you ll receive:

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

Required:

  • Experience with delivering large technology programs, establishing high performing teams, and selling client projects

  • Demonstrated understanding of the health insurance business (Commercial [Employer and Individual], Medicare, Medicaid, Federal Employee Program, HealthCare Exchanges)

  • Expertise in three or more of the following health plan functional areas: membership and enrollment, billing, claims and claim payables, products and benefits, provider services, provider networks, provider reimbursement methodologies, authorizations, utilization management, care management, customer service

  • Understanding of the health care industry, including market landscape, regulatory environment, and industry trends

  • Proficient in MS Office (PowerPoint, Excel, Word)

  • Strong leadership and management skills

  • Ability to provide strategic leadership and demonstrate the ability to develop future state scenarios, create a vision for the future, and define factors and key actions needed to achieve success

  • Proven critical thinking and problem-solving skills on business and technical constructs

  • Work effectively in cross functional team environment

  • Proactive and open to learning new technologies

  • Excellent written and verbal communication skills

  • Strong work ethic; comfortable working in a fast-paced environment

  • Ability to lead peers through influence and vision

  • Executive-level communication skills

  • No sponsorship

Education and experience:

  • Bachelor s degree in computer science or relevant field from an accredited college or university

  • 5 years of relevant professional experience in a large, diverse, multi-location environment

  • 5 years experience within the health care industry, specifically focused on health insurance core administration functions and platforms

  • Experience with large ($40M ) technology program management and developing high impact teams to deliver complex projects

  • Extensive experience in health insurance claims processing and system configuration with a minimum of 3-5 years experience

  • SDLC (system development life cycle) management experience in waterfall, agile, and/or scaled agile

  • Experience in one of the following types of projects in health plans: core administration platform configuration, core administration migration, operational and IT solution design, operational and IT impact assessments, system evaluation and selection, or application rationalization

  • Experience building and overseeing a team, including training resources, establishing and sharing best practices, and managing resources across multiple projects

Additional desiredskills (optional):

  • HealthEdge HealthRules Payor experience

  • Facets / QNXT experience

  • Oracle Health Insurance Solutions experience

  • Epic Tapestry experience

  • Provider data migration experience

  • Health plan configuration experience

  • Master s degree from an accredited college or university

Example of a project assignment:

  • Lead benefits / products, provider, contracting, and other configuration efforts

  • Provider demographic and pricing set up to support platform migration

  • Build out and roll out of product build out/configuration in support of membership migration

  • HealthEdge configuration lead

How you ll grow:

Deloitte Global inspires leaders at every level. We believe ininvesting in you, helping you embrace leadership opportunities at every step ofyour career, and helping you identify and hone your unique strengths. Weencourage you to grow by providing formal and informal development programs,coaching and mentoring, and on-the-job challenges. We want you to askquestions, take chances, and explore the possible.

Benefits you ll receive:

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

Required:

  • Experience with delivering large technology programs, establishing high performing teams, and selling client projects

  • Demonstrated understanding of the health insurance business (Commercial [Employer and Individual], Medicare, Medicaid, Federal Employee Program, HealthCare Exchanges)

  • Expertise in three or more of the following health plan functional areas: membership and enrollment, billing, claims and claim payables, products and benefits, provider services, provider networks, provider reimbursement methodologies, authorizations, utilization management, care management, customer service

  • Understanding of the health care industry, including market landscape, regulatory environment, and industry trends

  • Proficient in MS Office (PowerPoint, Excel, Word)

  • Strong leadership and management skills

  • Ability to provide strategic leadership and demonstrate the ability to develop future state scenarios, create a vision for the future, and define factors and key actions needed to achieve success

  • Proven critical thinking and problem-solving skills on business and technical constructs

  • Work effectively in cross functional team environment

  • Proactive and open to learning new technologies

  • Excellent written and verbal communication skills

  • Strong work ethic; comfortable working in a fast-paced environment

  • Ability to lead peers through influence and vision

  • Executive-level communication skills

  • No sponsorship

Education and experience:

  • Bachelor s degree in computer science or relevant field from an accredited college or university

  • 5 years of relevant professional experience in a large, diverse, multi-location environment

  • 5 years experience within the health care industry, specifically focused on health insurance core administration functions and platforms

  • Experience with large ($40M ) technology program management and developing high impact teams to deliver complex projects

  • Extensive experience in health insurance claims processing and system configuration with a minimum of 3-5 years experience

  • SDLC (system development life cycle) management experience in waterfall, agile, and/or scaled agile

  • Experience in one of the following types of projects in health plans: core administration platform configuration, core administration migration, operational and IT solution design, operational and IT impact assessments, system evaluation and selection, or application rationalization

  • Experience building and overseeing a team, including training resources, establishing and sharing best practices, and managing resources across multiple projects

Additional desired skills(optional):

  • HealthEdge HealthRules Payor experience

  • Facets / QNXT experience

  • Oracle Health Insurance Solutions experience

  • Epic Tapestry experience

  • Provider data migration experience

  • Health plan configuration experience

  • Master s degree from an accredited college or university

Example of a project assignment:

  • Lead benefits / products, provider, contracting, and other configuration efforts

  • Provider demographic and pricing set up to support platform migration

  • Build out and roll out of product build out/configuration in support of membership migration

  • HealthEdge configuration lead

How you ll grow

At Deloitte, ourprofessional development plan focuses on helping people at every level of theircareer to identify and use their strengths to do their best work every day.From entry-level employees to senior leaders, we believe there s always room tolearn. We offer opportunities to help sharpen skills in addition to hands-onexperience in the global, fast-changing business world. From on-the-joblearning experiences to formal development programs at Deloitte University, ourprofessionals have a variety of opportunities to continue to grow throughouttheir career. Explore Deloitte University, The Leadership Center. at https://zoomforth.com/s/deloitte/du#home

Benefits

At Deloitte, we knowthat great people make a great organization. We value our people and offeremployees a broad range of benefits. Learn more about what working at Deloitte can mean for you. at http://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html

Deloitte s culture

Our positive andsupportive culture encourages our people to do their best work every day. Wecelebrate individuals by recognizing their uniqueness and offering them theflexibility to make daily choices that can help them to be healthy, centered,confident, and aware. We offer well-being programs and are continuously lookingfor new ways to maintain a culture where our people excel and lead healthy,happy lives. Learn more about Life at Deloitte.

Corporate citizenship

Deloitte is led by apurpose: to make an impact that matters. This purpose defines who we are andextends to relationships with our clients, our people and ourcommunities. We believe that business has the power to inspire andtransform. We focus on education, giving, skill-based volunteerism, and leadershipto help drive positive social impact in our communities. Learn more about Deloitte s impact on the world. at http://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-corporate-citizenship.html

Recruiter tips

We want job seekersexploring opportunities at Deloitte to feel prepared and confident. To help youwith your interview, we suggest that you do your research: know some backgroundabout the organization and the business area you re applying to. Check out recruiting tips from Deloitte professionals. at http://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html

Category: Management Consulting

About Deloitte

As used in this document, Deloitte means Deloitte LLP and its subsidiaries. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. 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.

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