Job Summary:

The Team Lead, Market Liaison Support Services (MLSS) will be responsible for leading a team of highly analytical professionals who specialize in root cause analysis and data-driven decision-making. This role requires a hands-on leader with deep functional knowledge of health plan systems, especially Facets, and experience with TFS and ServiceNow platforms for issue tracking and resolution, along with, project management skills, and a proven track record of driving issues to resolution.

The Team Lead will work cross-functionally with business, IT, and operational teams to uncover root causes of systemic issues and drive process improvements that enhance operational efficiency, compliance, and member/provider satisfaction.

Essential Functions:

- Lead and mentor a team of specialized analysts, fostering a culture of continuous improvement and analytical thinking.

- Conduct root cause analysis to identify underlying issues and develop actionable solutions.

- Oversee data analysis initiatives, ensuring accurate and timely reporting to inform decision-making.

- Manage projects and inventory from inception to completion, ensuring deliverables are met on time and within scope.

- Collaborate with cross-functional teams to drive operational improvements and enhance service delivery.

- Utilize ServiceNow, Facets, and TFS platforms for tracking issues, managing workflows, and ensuring effective resolution.

- Develop and implement best practices for data analysis and operational processes.

- Monitor team performance and provide regular feedback to team members to promote professional growth.

- Prepare and present reports to senior management on team performance, project status, and operational metrics.

Education and Experience:

• Bachelor’s Degree or equivalent years of relevant work experience is required
• 5+ years of experience in health plan operations, with a focus on claims processing, authorizations, or provider data
• Prior leadership or supervisory experience is required

Competencies, Knowledge and Skills:

• Strong proficiency level with Microsoft Word, Excel, PowerPoint, PowerBI & Visio
• Advanced troubleshooting and problem-solving capabilities
• Strong hands-on experience with Facets – specifically in claims adjudication and healthcare knowledge
• Proven ability to synthesize complex technical findings into concise, actionable Executive Summaries for business and executive audiences
• Excellent analytical, investigative, and documentation skills
• Strong communication skills with the ability to explain complex system issues and solutions to both technical and non-technical audiences
• Proven ability to work independently and manage multiple priorities in a fast-paced environment

Compensation Range:

$70,800.00 - $113,200.00

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

• 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.

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