Director, Network and Benefits Configuration

Job Title:               Director, Network and Benefits Configuration

Reports To:          Vice President — Information Technology Services
 

The Director of Network and Benefit Configuration is responsible for maintaining all provider network and benefits adjudication configuration within SIHO core benefit administration systems. This position works effectively with all SIHO departments to ensure the needs of current and future customers are properly configured for benefits processing. The position develops and helps to enforce standard policies and procedures supporting each distinct configuration. The position also performs and/or leads audits of system data directly or indirectly related to this function.
 

Brief Description of Duties:

• Creates and executes project work plans and revises as appropriate to meet changing needs and requirements.
• Understands all system modules and how they interact and interface together.
• Leads network configuration related implementations including completing project scoping, assignment of tasks, and project assessments.
• Effectively utilizes each team member to his/her fullest potential.
• Motivates team to work together in the most efficient manner.
• Continually seeks opportunities to increase customer satisfaction.
• Suggests areas for improvement in internal processes along with possible solutions.
• Liaison between SIHO and networks regarding provider maintenance/pricing and problem claims.
• Designs/implements/maintains new networks and benefits in SIHO core adjudication platform.    Assist all other SIHO departments in interpretation and application of benefit load requirements and standard.
• Designs/implements/maintains pricing structures associated with networks/partners/providers to ensure correct pricing and auto-adjudication.
• Designs/implements/maintains system audits to ensure system accuracy and consistency.  
• Other IT projects as requested.

Minimum Skills Requirement:

• Degree or equivalent work experience in a managed care organization.
• Ability to communicate clearly in oral and written presentations.
• General knowledge and understanding of the health care benefits industry.
• Demonstrated ability as a problem solver. (i.e., use of analytic and logic skills)  
• Maintain confidentiality in all levels of internal and external communications.
• Ability to project and maintain a positive attitude internally and external.
• Ability to work independently or as a member of a team.  
• Professional appearance and presence.

Other:

• Computer skills: Microsoft Excel, Word, Outlook, Al

Revised: 07/31/2025                                       SIHO Insurance Services • Columbus, IN