Job description

Project Summary

CareSource is in the growth mode and on Facet 6;2 version and Agile and Scrum
They are prepping for multiple new market implementations and integrations in 2025.

Essential Functions

Tricare is the Federal Health Insurance for active and retired military and their families. The Federal Government has split the US into 2 regions - West and East and awarded the West Region to TriWest (Phoenix) and East to Humana. We are not clear on Caresource's involvement with Tricare claims processing, however, they are looking for resources with Tricare experience - initially a Claims workflow SME who has recent Tricare experience.

Top Five Skills Required

Min 4 years recent experience supporting Claims workflow/requirements for Tricare Line of Business
Overall min 10 years of business/operation side of claims processing/workflow experience
Must be able to interpret and define business requirements related to claims processing for Tricare
Must be able to develop use cases supporting claims processing
The ability to support UAT Testing

Nice to have skills

Facets experience is preferred

Education

Bachelor's

Required profile