Director – Configuration Implementation

6 hours ago

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HealthEdge

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Healthcare Insurance • SaaS • Fintech

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

1001 - 5000 employees

Founded 2005

⚕️ Healthcare Insurance

☁️ SaaS

💳 Fintech

📋 Description

• Lead customer discovery sessions and requirement workshops with health plan stakeholders • Support sales cycles including but not limited to RFP responses, Statement of Work and proof-of concept development • Develop resource (FTE) estimates and financial projections for implementation • Lead, mentor and supervise multiple implementation teams, ensuring alignment with project goals and client expectations • Monitor the progress of implementation projects to ensure the teams meet critical milestones and deliverables • Establish and cultivate strong relationships with client leadership to drive successful project outcomes and serve as a primary point of escalation when necessary • Provide guidance to teams on the product and deliver effective solutions to complex issues, ensuring timely problem resolution • Spearhead innovation by architecting process solutions across HealthRules Payor modules to develop scalable, reusable configuration accelerators • Evaluate post-implementation reviews to assess project success and identify opportunities for continuous improvement • Support the transition of all implementation projects to the ongoing support teams, ensuring a seamless handover and continued support • Collaborate with cross-functional teams to enhance configuration outcomes and drive continuous improvement • Should be flexible in work roles and hours • Must be able to travel

🎯 Requirements

• Bachelor’s degree in computer science, Business Administration, Healthcare Administration, or related field preferred • Must have Leadership and Mentorship experience • Minimum of 8 years hands-on HealthRules Payor configuration experience • High proficiency in multiple HealthRules Payor components including but not limited to Pricing, Benefits, Claims, Utilization Management • Minimum of 10 years total experience in healthcare claims processing or health plan operations • Proficiency in one or more third party claims pricers and/or claims editing solutions • Proven track record of successful large-scale HealthRules Payor implementations • Must have experience working with customers • Previous consulting experience

🏖️ Benefits

• HealthEdge commits to building an environment and culture that supports the diverse representation of our teams • We aspire to have an inclusive workplace • We aspire to be a place where all employees have the opportunity to belong, make an impact and deliver excellent software and services to our customers