
1001 - 5000 employees
Founded 2005
🏥 Healthcare
💼 Consulting
⚕️ Healthcare Insurance
Healthcare • Consulting • Healthcare Insurance
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.
🕒 September 3
🇺🇸 United States – Remote
💵 $80k - $110k / year
⏰ Full Time
🟠 Senior
⚙️ Operations
🦅 H1B Visa Sponsor
👻 Ghost score 12%
Improve your chances of getting an interview by checking your resume score before you apply.

1001 - 5000 employees
Founded 2005
🏥 Healthcare
💼 Consulting
⚕️ Healthcare Insurance
Healthcare • Consulting • Healthcare Insurance
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.
• Manage operational excellence for technology delivery • Generate SLA and operational reports for customers and management • Drive incident resolution and root cause analysis • Manage day-to-day production support for a mid-size health plan, including core administrative systems for enrollments, claims, adjudication, and payments • Support surrounding applications/products and downstream and upstream vendors • Drive customer calls and priorities • Prioritize daily operational events and issues • Manage incidents in service management systems such as JIRA and ServiceNow • Manage change and issue resolution with network, middleware, hardware, OS, database, and external application groups • Plan system maintenance and upgrade events across multiple vendors • Resolve customer escalations • Work across multiple time zones in a hybrid or remote work environment • Travel as required by company needs
• Bachelor’s degree in a related field • Minimum of 6 years’ experience managing a mid to large size customer facing production support environment • Strong experience working with healthcare payer platforms, such as Facets, QNXT, or NASCO • Strong experience with service management, SLA tracking, and operational reporting • Strong experience with file transfer management solutions, such as MoveIt or EDIFECS • Experience setting up processes using service management tools, preferably Service Now and Jira Service Management • Experience with Healthcare EDI, such as 270, 271, 276, 277, 834, or 835, highly desirable • Experience managing production application environments • Experience in a technical support role in a complex architecture environment • SQL experience required • Cloud AWS/GCP experience desirable • SOAP experience desirable • ETL processing experience desirable • Understanding of ITIL practices and software delivery • ITIL certification or strong working knowledge of ITIL-based operations • Practical knowledge of SOWs, SLAs, and Change Requests • Experience with SaaS providers and HealthEdge applications is a plus • Experience in delivery management and customer partner or account interaction is required • Experience working in an onshore/offshore model is required • Candidates may be required to complete a pre-employment criminal background check
• Remote work environment • 5% travel allowance/requirement • Reasonable accommodations for individuals with disabilities • Equal opportunity and workforce diversity commitment
Apply Now🕒 September 3
Data Operations Support Lead overseeing AWS data governance, pipelines, analytics, and AI/ML operations. Supporting GDIT’s Case Management Modernization program for U.S. federal courts.
🇺🇸 United States – Remote
💵 $169.6k - $229.5k / year
⏰ Full Time
🟠 Senior
⚙️ Operations
🦅 H1B Visa Sponsor
🕒 September 3
Campaign Operations Specialist managing tracking, attribution, routing, and launch readiness for digital advertising partners. Auditing campaigns and producing performance reporting and reconciliation.
🕒 September 3
Patient Services Representative handling patient billing calls and self-pay collections for University of Maryland Faculty Physicians. Investigating accounts, resolving patient questions, and conducting follow-up.
🇺🇸 United States – Remote
💵 $18 - $28 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
⚙️ Operations
🦅 H1B Visa Sponsor
🕒 September 3
Marketing operations manager owning HubSpot, Salesforce, and PartnerStack systems for ChowNow’s restaurant technology platform. Improving lead routing, attribution, campaigns, and partner-sourced pipeline.
🇺🇸 United States – Remote
💵 $120k - $152k / year
💰 $21M Series C on 2019-05
⏰ Full Time
🟡 Mid-level
🟠 Senior
⚙️ Operations
🦅 H1B Visa Sponsor
🕒 September 3
Senior Payment Operations Specialist managing reconciliations, exceptions, and compliance for Nomi Health’s healthcare payment solutions. Partnering with Product and Technology to improve platform reliability.
🇺🇸 United States – Remote
💰 $110M Series A on 2021-12
⏰ Full Time
🟠 Senior
⚙️ Operations
🦅 H1B Visa Sponsor