Avalon Healthcare Solutions

Full-stack Engineer

• Serve as the client-facing subject matter expert on all aspects of technical integration delivery.
• Capable of discussions with client IT resources, client operations staff and program intermediaries in their terms.
• Manage concurrent client implementations with complex business requirements across Pre-Pay and Post-Pay data exchanges, configurations, validations, and production readiness with minimal oversight.
• Work with Project team to Develop and execute implementation plans for projects and initiatives, ensuring that all stakeholders are informed and engaged throughout the process.
• Ensure successful implementation of Avalon’s LBM programs by managing technical integration activities around onboarding tasks, technical requirements gathering, development, testing, and deployment phases.
• Lead and document data mapping and GAP analysis sessions for program data files and extracts with clients and intermediaries.
• Maintain traceability for technical risks, issues, assumptions, decisions, owners, impacts, and possible mitigations plans.
• Work with Delivery Owners and Project Managers to escalate unresolved technical risks, defects, and data quality issues, which may impact the implementation.
• Collaborate with internal Avalon teams to define and clarify technical requirements, and ensure timely execution of deliverables aligned with project timelines.
• Coordinate setup of secure system access (e.g., SSO, SFTP) for client users and providers.
• Create and manage technical work items (e.g., JIRA tickets) for development and configuration tasks.
• Generates reports and dashboards utilizing bi-tools such as Tableau.
• Support end-to-end user acceptance testing (UAT), including planning, execution, and issue resolution.
• Performing data validations and data analysis, using SQL tools to generate complex queries for research and testing.
• Translate business needs into clear functional and technical specifications for development and testing teams, while effectively communicating technical requirements, solutions, and issues to business stakeholders in a clear and actionable manner.
• Collaborate with internal and external stakeholders to identify, develop, and deliver process improvements that enhance efficiency and project quality, reducing overall implementation timelines.
• Act as a business owner of all technical integration-related materials within the Avalon Implementation Toolkit, including the Implementation Guide and supplemental specifications.
• Identify and drive process and solution improvements to enhance implementation efficiency, shorten delivery time and reduce defects while never compromising on quality.
• Support and Author Technical Integration documentation and process flows.

Technical Implementation Integration Lead

Scrum Master

• Coordinating and managing agile ceremonies including Iteration Planning, Stand Ups, Refinement, Iteration Review, and Retrospective.
• Removing impediments or guiding the team to remove impediments through coordination and creative thinking.
• Coordinating with Product and Development Managers to facilitate PI planning and ensure that PI objectives are attained.
• Responsible for improving flow.
• Analyzing iteration data to determine potential risks of meeting iteration goals.
• Assisting with internal communication, improving transparency, and radiating information.
• Facilitating discussion, decision making, and conflict resolution.
• Contributing to the advancement and improvement of Agile practices within the organization.
• Coordinating with other scrum masters to develop best practices and standards for agile teams at Avalon.

General Counsel

• Serve as a strategic advisor to the CEO, Board of Directors, and Executive Leadership Team on legal, regulatory, governance, and enterprise risk matters.
• Serve as Corporate Secretary, overseeing Board governance, resolutions, committee support, and corporate records.
• Advise leadership regarding strategic initiatives, acquisitions, joint ventures, investments, and other corporate transactions.
• Develop legal strategies that enable business growth while appropriately managing organizational risk.
• Build trusted relationships across the organization as a collaborative business partner and advisor.
• Lead all legal affairs of the organization, including commercial transactions, litigation management, employment matters, intellectual property, corporate governance, and regulatory compliance.
• Draft, negotiate, and oversee complex commercial agreements with a primary focus on healthcare payer contracts, provider agreements, strategic partnerships, technology agreements, vendor contracts, and business associate agreements.
• Provide legal guidance on new products, strategic initiatives, artificial intelligence, data use, and healthcare innovation.
• Manage legal risks associated with corporate operations and recommend practical business solutions.
• Direct all litigation, dispute resolution, and legal investigations while managing outside counsel.
• Serve as the executive legal advisor for all healthcare payer contracting activities.
• Lead legal negotiations involving national and regional health plans, delegated service agreements, value-based arrangements, and strategic partnerships.
• Partner with Commercial, Operations, Product, and Clinical leadership to structure innovative client agreements while protecting Avalon's legal and financial interests.
• Advise leadership on reimbursement, delegation, utilization management, privacy, and regulatory implications of contractual arrangements.
• Provide executive oversight of the Corporate Compliance and Privacy programs.
• Ensure organizational compliance with HIPAA, HITECH, CMS, NCQA regulations, state insurance regulations, fraud, waste and abuse requirements, and other applicable healthcare laws.
• Oversee enterprise compliance investigations, corrective action plans, and regulatory reporting.
• Direct privacy governance, breach response, and enterprise data protection strategies.
• Foster a culture of ethics, integrity, and compliance throughout the organization.
• Provide executive oversight of the Internal Audit function and enterprise risk management activities.
• Establish risk-based audit priorities that support operational excellence and regulatory compliance.
• Monitor organizational risks and ensure appropriate mitigation strategies are implemented.
• Present audit findings, risk assessments, and compliance updates to executive leadership and the Board.
• Lead the organization's government affairs strategy at both the federal and state levels.
• Develop relationships with legislators, regulators, industry associations, and other key stakeholders.
• Manage lobbying activities and outside government affairs consultants.
• Monitor legislative and regulatory developments affecting Avalon and proactively advise executive leadership.
• Represent Avalon before governmental agencies and industry organizations as appropriate.
• Lead and develop a high-performing legal, compliance, privacy, audit, and government affairs organization.
• Provide coaching, mentoring, and career development for direct reports and department staff.
• Manage departmental budgets, outside legal counsel, consultants, and vendor relationships.
• Establish departmental goals, performance metrics, and succession plans.
• Drive operational excellence through process improvement and technology enablement.

Chief Legal Officer

Project Manager

• Simultaneously manage multiple complex projects with significant technical and operational demands.
• Lead end-to-end implementation efforts, directing cross-functional internal and external teams to ensure high-quality, on-time delivery aligned with both Avalon’s strategic goals and client expectations.
• Foster strong working relationships across a matrixed organization, influencing without direct authority.
• Develop and tailor comprehensive project plans, applying appropriate project management frameworks to meet the unique requirements of each client and initiative.
• Apply strategic, end-to-end thinking to drive execution across all phases of the project lifecycle.
• Create and maintain critical project documentation, including Charters, RAID Logs, Project Plans, Milestone Charts, Work Breakdown Structures (WBS), Status Reports, Meeting Agendas/Notes, and Communication Plans.
• Deliver clear and impactful project reporting (e.g., Status Reports, Steering Committee decks), ensuring all stakeholders remain informed, aligned, and engaged throughout the project lifecycle.
• Coordinate and oversee multiple interdependent workstreams—such as Data Integration, Clinical Policy, Testing, Provider/Workforce Training, Prior Authorization, and Utilization Management—to maintain alignment and drive project momentum.
• Communicate with clarity and precision in both verbal and written formats, ensuring alignment across project teams, leadership, and clients.
• Lead issue and risk management processes: proactively identify risks, implement mitigation strategies, and manage timely issue resolution and escalation pathways.
• Facilitate collaborative, cross-functional problem-solving discussions to identify innovative and effective solutions.
• Ensure all project activities adhere to internal policies, procedures, and governance standards.
• Serve as a subject matter expert (SME) on Avalon’s programs, supporting requirements gathering and internal solution design in collaboration with other SMEs.
• Lead or contribute to internal process improvement initiatives, leveraging formal methodologies to enhance efficiency and maintain thorough documentation, including workflows, SOPs, and job aids.
• Participate in and lead internal projects and cross-organizational initiatives to drive operational excellence and strategic alignment.

Data Engineer

• The Data Engineer, AI Enablement develops and maintains data pipelines and datasets that support analytical reporting and artificial intelligence solutions.
• Using a variety of data engineering methods, this role works with structured, semi-structured, and unstructured data to prepare datasets for analytics, artificial intelligence, agents, and modeling use cases.
• Support the construction and ongoing maintenance of data structures used for data-driven and AI-enabled analyses.
• Assess and report on data quality and contribute to efficiency improvements by aligning data and AI systems with defined business and analytical goals.
• Enable analysts, AI developers, and business stakeholders to access, consume, and operationalize valid and reliable data across internal and external use cases.

Data Engineer II, AI Enablement

Onboarding Specialist

• Partner with cross-functional teams at both the program and enterprise level — spanning Scientific Affairs, Policy, IT, and Enforcement — to align on client requirements, resolve issues quickly, and ensure a cohesive implementation experience from start to finish.
• Serve as the primary point of contact and trusted advisor for clients throughout the full implementation lifecycle, ensuring a seamless and supported experience.
• Manage multiple client engagements simultaneously, keeping projects organized, on schedule, and aligned with each client's unique needs and expectations.
• Develop and lead implementation plans that keep all client and internal stakeholders informed, engaged, and confident in the process from kickoff through go-live.
• Clearly communicate program capabilities, workflows, and integration expectations to clients and partners in straightforward, accessible language.
• Guide clients through each phase of the LBM implementation journey — including onboarding, requirements gathering, testing, and launch — ensuring clarity and accountability at every step.
• Lead collaborative working sessions with clients to gather and document data and file requirements, ensuring all parties are aligned before work begins.
• Partner with internal teams to define requirements, coordinate deliverables, and serve as the client's advocate in ensuring timely and quality execution.
• Walk clients and end users through system access setup and onboarding, ensuring a smooth and well-supported experience from the start.
• Track and manage client-related action items and deliverables, ensuring nothing falls through the cracks and stakeholders are always aware of progress and next steps.
• Support clients through the testing and validation process, helping to address questions, resolve issues, and ensure readiness for launch.
• Act as the bridge between client needs and internal teams — translating business goals and feedback into clear direction for configuration and delivery.
• Partner with clients and internal stakeholders to proactively identify opportunities to streamline the implementation experience and reduce unnecessary complexity.
• Serve as the steward of client-facing implementation resources and documentation, ensuring materials are clear, current, and easy for clients to navigate.
• Continuously look for ways to improve the client implementation experience, reduce friction, and deliver better outcomes faster.

Client Integration Lead – Implementations

• Develop low-to-medium complexity design documents and contribute to application diagrams from defined requirements.
• Take on small to medium tasks and drive them to completion with minimal coaching, including small research tasks and basic design work.
• Support the growth of QA team members and junior engineers, and participate in code reviews for peers, applying and adhering to established coding best practices and procedural standards.
• Support quality delivery by following the team's definition of done and flagging potential issues when identified.
• Develop and execute unit test plans, including regression testing, and assist in developing functional test plans to verify system functionality according to requirements and guidelines.
• Perform application administration and support, triaging and resolving integration issues, documenting, and tracking product defects, and implementing solutions.
• Participate in on-call rotation schedule.
• Contribute to and follow Avalon’s Agile/SAFe process for developing, testing, maintaining, and deploying code.
• Collaborate with product owners, engineering leads, and architects, aligning IT solutions with business objectives.
• Adhere to the defined SDLC: Write code and tests that adhere to the company defined SDLC (software defined delivery lifecycle). Ensure all work complies with the team's definition of done.
• Incorporate AI tools into daily development workflows across code generation, debugging, research, and writing tests and documentation. Must review and validate all AI-generated output before submission and transparently flag AI usage to senior engineers or leads for appropriate oversight and review.
• Evaluate and adopt new technologies or tools that enhance system performance maintainability.
• Work effectively within the immediate team and occasionally across other teams or enabler teams. Communicate clearly with the engineering manager, product owner, and scrum master. Explain medium-complexity problems and demonstrate completed work in sprint demos.

Software Engineer II

General

• Supervise, coach, develop, and evaluate a team of Quality Improvement Specialists
• Establish team goals, performance expectations, and productivity standards
• Monitor workload distribution and ensure timely completion of quality audits, reporting, and improvement initiatives including ad hoc requests and shifting of priorities as new tasks arise.
• Provide ongoing training, mentoring, and professional development opportunities
• Support hiring, onboarding, performance management, and succession planning activities
• Foster a culture of accountability, continuous improvement, collaboration, and customer service
• Perform and oversee quality auditing activities, including review and analysis of claims data, identification of trends, development of recommendations, and monitoring of corrective actions
• Review audit findings and reports for accuracy, consistency, and completeness
• Monitor quality performance metrics and identify opportunities for process improvement
• Conduct root cause analyses and facilitate corrective action planning with operational stakeholders
• Support development, implementation, and evaluation of quality improvement initiatives
• Ensure quality activities are aligned with organizational priorities, client expectations, and regulatory requirements
• Complete and oversee monthly, quarterly, and annual quality reporting activities
• Assist in the development, maintenance, and evaluation of the annual Quality Improvement Work Plan
• Monitor QI Work Plan metrics and performance trends, escalating concerns and recommending solutions as appropriate
• Support delegation oversight activities, internal audits, and operational policy reviews
• Collaborate with cross-functional teams to ensure accurate implementation of medical and claims payment policies
• Analyze claims, operational, and quality performance data to identify trends, risks, and opportunities
• Develop and present quality performance reports, audit findings, and recommendations to leadership
• Ensure accuracy and integrity of quality data, reporting methodologies, and audit documentation
• Partner with operational leaders to measure effectiveness of improvement initiatives and validate outcomes

Supervisor, Quality Improvement

Analyst

• Perform analyses of Avalon laboratory benefits management configuration in order to determine and create use cases for regression testing.
• Ability to take requirements from medical policy translation documents and successfully incorporate these as rules in the Avalon laboratory benefits management configuration file.
• Run regression testing prior to Production releases for Avalon Claim Editor to ensure optimal functionality of the Claim Editor.
• Development and maintenance of ReadyAPI! test suite for regression testing management.
• Validate and/or provide input to LBM global rules process flows.