The role is responsible for setting enterprise priorities for operational reporting, dashboards, and business process automation. It acts as a strategic partner to Operations, Product, and Technology leadership to translate business needs into actionable data and technology requirements.
The Claims Examiner II is responsible for adjudicating healthcare claims by reviewing data against specific policies and benefit coverage criteria. The role also involves meeting productivity and accuracy standards while collaborating on special projects and mentoring junior team members.
The Senior Software Engineer will design and develop Java-based application components while contributing to the product suite's future direction. They will work within an agile team to implement new features, perform system testing, and provide ongoing solution support.
The Atlassian Administrator is responsible for the day-to-day configuration, maintenance, and user support of Jira, JSM, and Confluence. They will manage platform requests, project configurations, and automation to ensure effective tool usage across the organization.
The Enrollment Quality Auditor performs audits of enrollment, disenrollment, and eligibility transactions to ensure accuracy against state and CMS standards. They also report findings to management and provide feedback to associates to improve production quality.
The Customer Service Associate will handle inbound and outbound calls to assist customers and document interactions in tracking systems. They will also act as a liaison between the claims department and providers while researching customer claims.
The Integration Lead will design technical architecture for customer delivery programs and ensure compliance across claims, enrollment, and payment systems. They will also collaborate with internal and external teams to identify automation opportunities and performance improvements.
The Senior Business Systems Analyst will own the integration layer across enterprise systems and manage the administration and adoption of the Claude Enterprise AI platform. They will partner with business stakeholders to automate processes, ensure system health, and translate technical requirements into scalable solutions.
The Manager provides strategic leadership and operational oversight for CMS-mandated RADV audits across Medicare Advantage and Commercial lines of business. This role is responsible for developing audit strategies, managing departmental performance, and fostering cross-functional partnerships to ensure regulatory compliance.
The Technical Operations Lead will manage operational excellence for technology delivery, including incident resolution and production support for health insurance systems. They are responsible for coordinating system maintenance, managing customer escalations, and ensuring timely SLA reporting.
The Claims Team Lead is responsible for managing a team of 12-15 claims examiners and adjusters to ensure operational excellence and high-quality claims processing. They must monitor productivity targets, maintain client-specified guidelines, and collaborate on special projects to improve operational efficiency.
The Manager of Claims Operations is responsible for managing claims inventory, tracking trends, and optimizing operational efficiencies to meet client goals. They will also coach staff, ensure regulatory compliance, and collaborate with cross-functional teams to improve claims processing workflows.
The Claims Quality Auditor performs audits of health plan transactions, including claims, enrollment, and billing, to ensure accuracy and quality. They report findings to management, provide feedback to associates, and coordinate with teams to identify opportunities for process improvement.
The Solution Architect will design and implement enterprise-wide integration solutions for the HealthProof core-admin ecosystem. They are responsible for leading technical architectural discussions, ensuring governance compliance, and mentoring technical staff.
The Director of Enterprise Reporting will lead the transformation of enterprise reporting initiatives, including the development of dashboards, scorecards, and data lake infrastructure. This role involves driving cross-functional alignment across operations, product, and technology teams to ensure consistent reporting standards and strategic execution.
The IT Support Specialist resolves complex escalations from T1 analysts and provides advanced troubleshooting for endpoints, identity, and infrastructure. They also serve as a technical resource and mentor to junior staff while coordinating with cross-functional teams to ensure system stability.
The Technical Operations Manager will oversee technology delivery operations, manage production support for health plan systems, and drive incident resolution. They are responsible for coordinating with offshore teams, ensuring SLA compliance, and managing system maintenance and upgrades.
The Network Engineer designs, implements, and optimizes enterprise network infrastructure across on-premises and cloud environments. They are responsible for 24/7 network operations, incident response, and the development of automation workflows to ensure high availability.
The Senior Cloud Infrastructure Engineer will own the design, resilience, and day-to-day health of infrastructure across AWS and hybrid environments. Responsibilities include managing disaster recovery, security compliance, CI/CD pipelines, and supporting cloud migration efforts.
You will design and develop large-scale, cloud-native, multi-tenant data services and pipelines to support healthcare provider data management. The role involves full ownership of the software development lifecycle, including planning, coding, testing, and performance optimization.
The FinOps Analyst will establish and operate a comprehensive cloud and SaaS financial management practice across multi-cloud environments. They will partner with engineering, finance, and product teams to ensure cost-efficient consumption, accurate reporting, and effective governance.
Provide strategic legal counsel for BPaaS and SaaS business lines, including drafting and negotiating complex commercial agreements. Serve as lead counsel on high-value transactions while ensuring compliance with healthcare regulatory and accreditation requirements.
The Senior Business Systems Analyst will own the Customer Success technology platform and lead the implementation of AI strategies to optimize GTM workflows. They will act as a trusted partner to GTM teams, designing scalable system solutions and measuring the business impact of technical implementations.
The Product Owner will manage the product backlog, translate business needs into actionable user stories, and collaborate with engineering teams to ensure high-quality delivery. They will also serve as the primary point of contact for development teams and engage with stakeholders to capture feature requests and feedback.
The Enrollment Specialist II is responsible for processing Medicare enrollment and disenrollment requests while ensuring accurate billing and member data maintenance. They also reconcile enrollment discrepancies and collaborate with team members on special projects to improve operational efficiency.
The Compliance Manager will serve as the operational integrator for the Compliance and Privacy Department by managing governance routines, strategic initiatives, and risk management frameworks. They will also facilitate cross-functional collaboration to ensure compliance requirements are embedded into business processes and monitor departmental performance through executive dashboarding.
The Software Engineer will develop and maintain synthetic data generation tools while troubleshooting performance bottlenecks in enterprise applications. They will also integrate performance testing into CI/CD pipelines and collaborate with cross-functional teams to optimize system scalability and reliability.
The Enrollment Team Lead oversees onshore and offshore enrollment specialists to ensure smooth operations within the Enrollment Operations Business Unit. Responsibilities include managing discrepancy queues, ensuring regulatory compliance with CMS guidelines, and driving process improvements to meet SLA targets.
The Product Manager will define and drive the AI product strategy for the HealthRules Payer platform, ensuring alignment with market needs and operational outcomes. They will lead cross-functional efforts to integrate AI capabilities across various value streams while maintaining compliance with healthcare regulations.
The Resource Analyst will manage and forecast the utilization of the global workforce to ensure optimal staffing for client implementations and advisory services. They will also provide data-driven operational insights to leadership to support hiring and delivery strategies.
Design and implement a new Atlassian Cloud foundation while managing the migration and consolidation of existing instances. Establish governance models, security standards, and AI-driven automation to support both internal engineering teams and external customer portals.
The Enrollment Specialist II is responsible for processing Medicare enrollment and disenrollment requests while ensuring accurate billing and member data maintenance. They also reconcile enrollment discrepancies and collaborate with team members on special projects and process documentation.
The Senior Manager will lead the global IAM program, overseeing strategy, operations, and the implementation of zero trust and privileged access management. They will also manage a team of 5-7 direct reports while partnering with stakeholders to ensure compliance with HIPAA, HITRUST, and SOC 2 standards.
The Senior Customer Success Executive is responsible for owning customer outcomes, driving retention, and identifying revenue expansion opportunities within the existing customer base. They act as a quarterback across cross-functional teams to ensure delivery, operational integrity, and the achievement of defined business objectives.
The Senior Enrollment Specialist is responsible for ensuring accurate member enrollment, billing, and data maintenance while resolving discrepancies. They also reconcile membership reports and collaborate on special projects to improve operational efficiency.
Serve as the primary onshore point of contact for customers and stakeholders while managing the EPLUS product on the Salesforce platform. Coordinate effectively between customers and internal offshore teams to ensure smooth operations and timely issue resolution.
The Principal Engineer will design and develop Java-based application components while collaborating with cross-functional teams in an agile environment. They are responsible for implementing new features, ensuring thorough testing, and providing solution support post-deployment.
The Manager will lead and develop a team of Principal Consultants, overseeing delivery quality, capacity, and client engagement standards. They will also serve as a senior functional authority, driving practice development and supporting pre-sales and scoping efforts.
Design, build, and operate secure AWS and Azure cloud infrastructure using Infrastructure as Code and CI/CD pipelines. Ensure platform reliability, security compliance with FedRAMP and HIPAA, and optimize operational costs through FinOps initiatives.
Develop and extend automation frameworks using Java to create comprehensive tests for complex data-driven applications. Collaborate with developers and product managers to identify testing gaps and improve CI/CD pipelines for seamless releases.
Design and deliver end-to-end BI dashboards in Tableau and Amazon QuickSight to provide actionable insights for executive and operational stakeholders. Collaborate with data engineers to refine AWS-based data sources and ensure high-quality data visualization and performance.
Serve as a strategic advisor to senior leadership to align people strategies with business outcomes and drive organizational transformation. Lead efforts in organizational design, workforce planning, and the development of a high-performance culture.
Design and implement comprehensive enterprise-scale security architectures encompassing network, application, and identity management. Lead strategic security visions and integrate advanced security controls and automation across the technology stack.
Lead operations strategy and service design for Core Administration BPaaS programs, focusing on future-state operating models and modernization. Support sales pursuits by translating BPaaS capabilities into business outcomes for health plan executives.
