Drive successful implementation and optimization of healthcare claims software solutions for clients.
Apply extensive understanding of healthcare claims processes, project organization skills, and relationship management skills.
Deliver mid- to complex software projects, accurately forecasting and scheduling business deliverables to meet project timelines.
Support end-to-end healthcare claims software implementation projects, within assigned Value Stream, ensuring alignment with client objectives and timelines.
Collaborate with other team members within assigned Value Stream.
Engage with clients and collaborate with clients to understand their needs and support the design of tailored software solutions that meet business requirements within assigned Value Stream, including handling configuration of HealthRules Payer and related solutions.
Identify potential project risks through proactive monitoring and develop mitigation strategies to ensure project success.
Identify functional gaps within HealthRules Payer suite.
Ensure quality assurance and compliance of mid- to complex healthcare claims software project deliverables.
Stay current with healthcare industry trends and best practices, continuously seeking opportunities to improve HealthEdge’s implementation processes.

Requirements

Bachelor’s degree in Computer Science, Information Technology, or HealthCare Administration, or a closely related field (foreign equivalent is acceptable) plus 5 years of employment experience in healthcare services industry.
A minimum of 5 years of demonstrated employment experience in business analysis and process improvement in healthcare.
A minimum of 5 years of demonstrated employment experience working with healthcare plans, claims, and benefits administration.
A minimum of 5 years of demonstrated employment experience guiding customers and facilitating resolution of customer issues.
A minimum of 3 years of demonstrated employment experience in system configuration, design, development, maintenance, application support, enhancement, and implementation of healthcare applications.
A minimum of 3 years of demonstrated employment experience using SQL query in Oracle to generate data reports for analysis and quality improvement.
A minimum of 3 years of demonstrated hands-on employment experience with HRP or equivalent core system experience.
A minimum of 3 years of demonstrated employment experience in project management and supporting project deliverables.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills

healthcare claims softwareproject managementbusiness analysisprocess improvementsystem configurationSQLOracleHealthRules Payerdata reportingapplication support

Soft skills

relationship managementproject organizationcollaborationclient engagementrisk identificationquality assurancecomplianceproblem resolutioncommunicationadaptability