Supervisor, Health Plan Business Systems Operations
Overview
The Supervisor, Health Plan Business Systems Operations will lead a team focused on delivering business solutions for complex health plan initiatives, including the configuration and implementation of new markets and products. This role requires strong system analysis, configuration design, testing, and documentation skills, as well as a high level of expertise in supporting governmental and commercial reimbursement policies.
The Supervisor will oversee claims and system administration activities, manage configuration and testing projects, and ensure platform functionality aligns with organizational goals. This individual will serve as a key liaison between departments, ensuring realistic project scopes, effective timelines, and the resolution of barriers. Experience with commercial health plans and strong leadership capabilities are essential. QNXT platform experience is highly preferred.
Education
Bachelor’s Degree (Required)
Certification/Licensure
No specific certification or licensure requirements
Experience
• Minimum 2 years of experience managing people or leading a team
• Highly experienced with configuration design, testing and documentation of commercial health plan benefits
• Strong understanding of Health Insurance claims processing systems; QNXT experience preferred
• 3+ years of experience with MS SQL Server, including writing SQL queries and working with SSAS, SSRS, and SSIS
• Proven ability to retrieve and analyze complex data using Microsoft Access, Excel, and SQL
• Proficient in process mapping/flow charting and documentation best practices
• Demonstrated ability to independently lead multi-functional projects and guide team members
• Strong organizational, verbal, and written communication skills
• Ability to coach, mentor, and manage workload across a team of analysts
• Experience in Managed Care, Medicaid, or Medicare Insurance environments
• Ability to apply sound judgment, troubleshoot complex issues, and influence process improvements
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