Technical Lead
- Infinite
- 6 - 8 years
- Bengaluru
- 5 months ago
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Job Description
- Configure, maintain, and validate ISNP plan structures in Plexis: benefit tiers, member cost-share (crossover subsidies, wrap-around benefits), enrollment effective dates, dual-eligible plan identifiers.
- Manage configuration team : assign Plexis setup tasks, monitor timelines, review outputs, coach specialists.
- Testing Quality Assurance : Develop and execute UAT scripts specific to ISNP (e.g., dual tracking, auto-enrollment from Medicaid, cost-sharing overrides), ensure configuration integrity across Plan Benefit Package (PBP) cycles.
- Cross-functional engagement : Work with care coordination, dual teams, IT, actuarial, compliance in particular ensure Plexis settings meet CMS and state Medicaid overlay rules, integrate rate cells and wraps properly.
- Change documentation and version control : Track configuration changes across PBP years, maintain version history in Plexis and documentation repository.
- Reporting/Monitoring : Generate dashboards showing configuration completeness, configuration errors logged, claims denial patterns tied to config; share insights to reduce configuration-related delays or denials.
- Continuous improvement : Identify automation or workflow improvements in Plexis configuration; remain current on SNP regulatory updates (e.g., CMS guidance on dual eligibility, Medicare envelopes).
- Compliance : Ensure Plexis-configured rules align with CMS, Medicaid, HEDIS, DE functional requirements.
- Bachelors degree (Healthcare Admin, Business, IT) or equivalent. Continued professional growth in SNP regulatory, configuration best practices encouraged.
- 6 8 years of health plan operations or configuration experience preferably with 1 3 years managing Plexis or similar system, especially in Medicare or SNP contexts.
- Must have direct experience with Plexis (or similar), configuring ISNP or dual-eligibility plan templates, cost-share overrides, state federal rules overlays.
- Skilled in UAT test design, issue tracking, resolution, configuration QA.
- Strong leadership background, cross-functional team coordination, vendor liaison.
- Analytical, detail-oriented, excellent communication.
- Tech-savvy: Plexis system, MS Excel (lookups ulas), project tracking tools, QA/test platforms.
Job Classification
Industry: IT Services & ConsultingFunctional Area / Department: Engineering - Software & QARole Category: Software DevelopmentRole: Technical LeadEmployement Type: Full timeContact Details:
Company: InfiniteLocation(s): Bengaluru
Keyskills: Automation Manager Quality Assurance Claims Analytical CMS Healthcare Workflow Actuarial Continuous improvement Testing
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