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At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

The Application Support Specialist Lead will support a Healthcare Care Management System platform for a state government market product, Long Term Services & Support (LTSS).  In this role you will lead a technical production support team focused on environment stability, processing optimization and issue resolution for this platform. 

Responsibilities: 

• Oversee and lead a team of production staff, including assigning tasks, monitoring workload & performance, and providing coaching and mentorship. Leads and drives continuous improvement initiatives, and implements strategic plans to enhance productivity while fostering a culture of accountability, collaboration and innovation.
• Leads and/or consults on system upgrades and system interfaces; performs system impact assessments.
• Leads team members, optimizing workflows, ensuring accuracy and compliance, and contributing to the improvement of overall system processing efficiency. 
• Leads an Application Production Support Team & provides in depth troubleshooting and product knowledge across multiple technologies/business units in support of system platform .
• Leads the design, testing, and validation of automation techniques to consistently improve technology and business processes in the production environment.
• Lead team members in completing their daily tasks efficiently and effectively, ensuring that team targets and goals are met. 
• Ensure compliance with all relevant state and federal health payer regulations, payer policies, and contractual agreements. 
• Maintain accuracy and efficiency in all aspects of production.  
• Analyze cross-technology and cross platform issues; identify bottlenecks in system processing workflows, proposing and implementing solutions to improve efficiency. 
• Troubleshoot and resolve defects/ issues with client concerns with a sense of urgency & ensure effective decision-making.
• Analyze production metrics and KPIs, providing actionable insights to drive performance enhancements.
• Identify trends, identifies anomalies and initiate recommendations for change to management.
• Partner with stakeholders to identify and develop workflow improvements. 
• Serves as the top escalation point on the team. For the most complex issues, the incumbent may conduct independent research to resolve issues.
• Develop and execute production schedules, ensuring timely and accurate processing of claims while maintaining a focus on cost efficiency.
• Collaborate with cross-functional teams, including vendors to optimize production workflows and resolve issues. 
• Prepare and provide daily, weekly, and monthly productivity report metrics.
• Facilitate team daily stand ups, meetings with business stakeholders, vendors, other IS teams.
• Acts as a mentor to less experienced staff, explaining relevant procedures and providing technical guidance. Train and educates staff on new process changes.
• Produces and maintains documentation on procedures, policies, and systems. 
• Supports technicians when ticket volume exceeds normal capacity. 
• Assists in the development of usage and user access policies and procedures. 
• Provide input to manager on staff performance relating to technology but does not prepare or deliver reviews. 
• Conducts complete diagnostics of most business problems, factoring in a strong understanding of the business & technical architecture. 
• Consults & supports moderate to large sized projects.
• Manage an assignment to resolve an escalated problem, implement upgrades, etc., usually lasting several months or less, which may require directing internal resources.

Qualifications / Education:

• Five to seven (5-7) years knowledge/ experience of HealthCare and/or Managed Care Organizations is preferred.
• Five to seven 5-7 years as a Subject Matter Expert in the Healthcare Payor industry, processing, application software support preferred.
• Knowledge/experience with government market lines of business (Medicaid, Medicare) is preferred.
• Some knowledge/ experience with Medicaid/Medicare LTSS (Long Term Services & Support) government product is a plus.
• Independent & strong analytical & problem-solving skills with a proactive approach to challenges. 
• A collaborative mindset, with open communication style and the ability to foster teamwork across departments.
• Adaptability and resilience in a fast- paced production environment.
• Applies technical skills independently and acts as a technical expert in one or more areas.
• Possesses a strong orientation towards customer service and a high level of professionalism. 
• Intermediate technical skills with .NET framework, Microsoft SQL (queries and stored procedures), SSIS, and Tableau is preferred.
• Knowledge of APIs, PowerShell Scripting and Amazon Web Services is a plus.
• Experience with Microsoft Office professional suite of product.
• BS in Computer Science or related fields, or Technical Certifications or equivalent years of experience. 
   

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.