Service Integration Analyst I

Job Summary:

The Customer Care Knowledge Specialist is responsible for the coordination, development and maintenance of the Service Operations knowledge repository that houses policies, procedures, process flows and job aids for consumer care representatives to utilize in response to member and provider call inquiries for Medicaid, Medicare, and future lines of business.

Essential Functions:

• Responsible for the coordination, development and maintenance of the Service Operations knowledge repository that houses policies, procedures, process flows and job aids for consumer care representatives to utilize in response to member and provide call inquiries for Medicaid, Medicare, and future lines of business
• Responsible for communication to Service Operations staff on new and revised policies, procedures, job aids, and process flow information within the knowledge repository as changes occur
• Identify, develop and design information for the knowledge repository for all teams in Service Operations
• Collaborate with other departments to develop and/or review cross-functional policies, procedures, process flows, and job aids
• Collaborate with Service Operation's teams on a regular basis to identify new or changing processes
• Attend departmental and project meetings to identify additional policies
• Point of contact for the department e-Manuals
• Develop and maintain Standard Operating Procedures for Service Operations
• Maintain a solid understanding of all policies and procedures to maintain Subject Matter Expert (SME) status
• Have a solid understanding of accreditation and regulatory requirements such as NCQA, URAC, OAC Rules, etc.
• Design and maintain a master list of policies, procedures and owners
• Lead the Service Operations Policy and Procedure Committee
• Communicate new policy and procedures to the appropriate Service Operations teams
• Communicate Standard Operating Procedure and organizational updates to Service Operations teams
• Job shadow with the teams in Service Operations to identify additional needed policies and procedures, training opportunities and/or additional e-Manual processes
• Perform any other job duties as requested

Education and Experience:

• High school Diploma or equivalent is required
• Associate's Degree is preferred
• Minimum of two (2) years of experience in a managed care or healthcare environment is required
• Minimum of two (2) years of experience in developing policies and procedures is required

Competencies, Knowledge and Skills:

• Intermediate proficiency level with Microsoft Word, Excel, Power Point and Share Point
• Visio experience is preferred
• Instructional design preferred
• Excellent writing skills
• Excellent communication skills
• General claims knowledge
• Ability to work independently and within a team environment
• Attention to detail and documentation
• Leading discussions
• Self-motivated, self-directed
• Understanding of managed care members, providers, claims and appeals processes
• Proper grammar usage
• Decision making and problem solving skills

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$46,500.00 - $74,500.00 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

Competencies:
- Create an Inclusive Environment
- 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 inclusive environment that welcomes and supports individuals of all backgrounds.