Job Summary:
The Director, Configuration Implementation will be responsible for leading the end-to-end implementation, configuration, and optimization of Facets and GuidingCare systems for a healthcare insurance company. This role requires deep expertise in payer platform configuration, system integration, and implementation strategy to ensure seamless deployment and operational efficiency. The Director will lead cross-functional teams, collaborate with key stakeholders, and drive best practices to enhance system functionality and business performance.
Essential Functions:
- Oversee the full lifecycle of Facets and GuidingCare configuration implementations, including planning, execution, testing, and go-live support
- Define and drive implementation strategies, roadmaps, and timelines to ensure successful deployments that meet business objectives and ensure alignment of system configurations with regulatory requirements, business rules, and operational needs
- Lead the Facets and GuidingCare configuration team to design, build, and optimize system settings, benefit structures, provider contracts operationalization, and workflow automation
- Ensure best-in-class configuration practices, enabling scalability and flexibility to support evolving business needs
- Develop a governance model for configuration management, including version control, auditability, and span-based configurations
- Partner with IT, operations, compliance, provider relations, and claims teams to align system capabilities with business and regulatory needs
- Work closely with vendor partners to implement system enhancements that support Medicaid and Exchange/Marketplace requirements
- Act as a bridge between business users and technical teams, translating operational requirements into system configurations
- Implement real-time system monitoring to proactively detect and address configuration-related issues before they impact business operations
- Establish processes for ongoing system audits and performance tracking to ensure stability and compliance
- Lead root cause analysis and resolution of system performance issues during and post-mplementation
- Build and mentor a high-performing implementation and configuration team, providing guidance, training, and career development opportunities
- Establish best practices and standardized procedures for Facets and GuidingCare configuration across new state implementations
- Perform any other job duties as requested
Education and Experience:
- Bachelor’s degree in Information Technology a related field, or equivalent years of relevant work experience is required
- Master’s degree is preferred
- Ten (10) years of experience in healthcare payer systems, with a strong focus on Facets and GuidingCare implementation and configuration
- Five (5) years in leadership roles, managing implementation teams and large-scale system deployments required
- Experience with system integrations, data migration, and API-driven automation in payer environments
Competencies, Knowledge and Skills:
- Knowledge of healthcare regulations (CMS, HIPAA, NCQA) and compliance requirements related to system configurations
- Strong project management and leadership skills, with experience in large, cross-functional implementations
- In-depth understanding of Facets modules (claims, provider, benefits, enrollment, billing) and GuidingCare care management workflows
- Excellent stakeholder management, communication, and problem-solving abilities
- Ability to drive automation, process improvement, and innovation in system configuration and implementation
- Familiarity with vendor management, contract negotiations, and service-level agreements (SLAs)
Licensure and Certification:
- None
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$110,800.00 - $193,800.00
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. 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
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Create an Inclusive Environment
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Cultivate Partnerships
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Develop Self and Others
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Drive Execution
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Influence Others
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Pursue Personal Excellence
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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.
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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