HealthEdge

IT Support

• Partner with team and department leaders for the delivery of project-based activities
• Provide estimates and project charter documentation for on-going and new initiatives
• Maintain direct control over project planning
• Develop and manage the overall program/project plans and timeline
• Partner with cross-functional teams to execute the migration strategy
• Identify and manage project risks and issues
• Ensure that project deliverables are high quality and meet customer requirements
• Communicate project status, risks, and issues to key stakeholders and executive leadership

IT Project Manager

Vice President

• Own the end-to-end payment integrity business strategy, operating model, and execution roadmap across the HealthEdge ecosystem
• Accountable for portfolio performance, business growth, and achievement of financial objectives associated with payment integrity solutions
• Define and execute a multi-year vision and transformation roadmap for payment integrity capabilities across the HealthEdge platform
• Drive innovation strategies leveraging AI, analytics, automation, and emerging healthcare technologies
• Lead business case development and investment strategies for new capabilities, partnerships, and market opportunities
• Establish payment integrity roadmap priorities in alignment with product, technology, and market strategies
• Drive executive-level client engagement strategies to accelerate adoption, retention, and expansion of payment integrity solutions
• Build and maintain strategic relationships with executive stakeholders across payer organizations and industry partners
• Establish clear operating rhythms, performance expectations, and accountability across the team
• Drive enterprise analytics strategy and insight-driven innovation for payment integrity capabilities in partnership with Data teams
• Partner with Data and Analytics teams to ensure accuracy, consistency, and rigor in payment integrity outputs
• Establish governance frameworks, executive reporting structures, and performance metrics to measure business impact and operational effectiveness
• Represent payment integrity priorities and business performance within executive leadership forums.

VP, Payment Integrity

Manager

• Coordinate and manage our Escalated Incident process activities.
• Supporting Escalated Incident Management reporting (KPIs and customer SLAs).
• Drives standard execution of the Escalated Incident Management process.
• Communicate with internal stakeholders and customer stakeholders as necessary about status, resolution and success criteria signoff.
• Record and classify received Incidents and undertake an immediate effort to restore failed services while working for most efficient time to restoration.
• Record all timelines, activities, resources and assets involved in the Incident.
• Associate Incidents with other records ( i.e. Incidents, Changes, Problems, Knowledge Articles, Known Errors, etc.).
• Own Root Cause Analysis process and delegate information requests to technical resources involved in restoration of service.
• Create, define and manage Technical Action Plans when escalated incidents occur.
• Work primarily is focused on Sev1 incidents, Sev2 incidents, Problem Management, Root Cause reviews and internal escalations.
• Collaboration skills and ability to work across technical and support teams.

Incident Manager

Network Engineer

• Design, configure, and maintain LAN/WAN, SD-WAN, VPN, firewall, and load-balancing infrastructure across multi-site and multi-cloud environments
• Monitor network performance (SolarWinds, Datadog, ThousandEyes) and proactively resolve issues before they impact service delivery and SLA targets
• Implement network security controls including firewall rule sets, IDS/IPS, segmentation, NAC, and zero-trust architecture principles
• Design and manage AWS network infrastructure — VPCs, subnets, route tables, IGW, NAT Gateways, and ELBs — for scalable, highly available architectures
• Configure AWS Transit Gateway and VPC peering for secure, low-latency connectivity across accounts, regions, and on-premises environments
• Implement AWS Direct Connect and Site-to-Site VPN for hybrid connectivity between HealthEdge data centers and AWS
• Administer AWS Route 53 including private hosted zones, resolver rules, and health-check-based routing policies
• Manage AWS Security Groups, Network ACLs, AWS Network Firewall, and AWS Shield for least-privilege access and DDoS protection
• Leverage AWS CloudWatch, VPC Flow Logs, and AWS Network Manager for observability, traffic analysis, and anomaly detection
• Support Azure or GCP networking as required — VNets /VPCs, peering, and hybrid connectivity
• Participate in 24/7 on-call rotation, triaging and resolving network incidents per SLA targets; contribute to post-incident reviews to drive MTTR reduction
• Execute network changes through established change management processes; serve as Tier 3 escalation resource for complex issues
• Develop automation scripts and IaC (Ansible, Terraform, CloudFormation, Python) to improve monitoring, alerting, and network deployment workflows
• Maintain topology diagrams, runbooks, IPAM, and change records; support DR testing, vendor coordination, and legacy environment consolidation
• Collaborate across Infrastructure, Security, DevOps, and Application teams; mentor junior team members

Project Manager

• Lead, coach, and develop a team of Project Managers and Senior Project Managers, including performance management, career development, and day-to-day guidance.
• Build a team culture grounded in accountability, transparency, and customer-focused execution.
• Own delivery outcomes across your team’s portfolio of customer engagements, ensuring projects are delivered on time, within scope, and within budget.
• Provide active oversight on complex and at-risk projects, helping PMs navigate escalations, resolve blockers, and maintain customer confidence.
• Ensure your team is consistently applying PMO delivery standards, governance practices, and reporting requirements.
• Partner with Delivery, Customer Success, Product, Technology and Operations leaders to align on priorities, resource needs, and execution sequencing across the customer lifecycle.
• Serve as an escalation point for your team and a reliable partner for internal stakeholders on delivery-related issues.

Senior Manager, Project Management

Analyst

• Analyze business requirements, configure and unit test software (HealthRules Payor)
• Ensure implementations are delivered successfully on time, and in alignment with project objectives by monitoring progress, identify risks and mitigation strategies, as needed
• Work independently to solve and test complex scenarios
• Analyze data and draw conclusions
• Demonstrate excellent communication skills

Payer Configuration Analyst

• Oversee a team of configuration analysts—both onshore and offshore—to ensure the successful delivery of a fully configured HealthRules system.
• Align implementation efforts with company standards and ensure all project milestones and goals are met.
• Play a leadership role to support and drive active implementation initiative, which will be client facing as well as working with other areas in the organization.
• Advise clients on their business problems as a Subject Matter Expert (SME).
• Monitor progress, identify risks and mitigation strategies, as needed.
• Collaborate with cross-functional teams to support seamless project execution.
• Lead and mentor a geographically distributed team (onshore and offshore), providing guidance, support, and resolution of complex issues to ensure high-quality deliverables and continuous professional development.

Configuration Manager

DevOps Engineer

• Design, implement, and maintain CI/CD pipelines for Java-based microservices and enterprise healthcare applications using tools like GitLab CI/CD, Jenkins, or similar.
• Customize CI/CD pipelines, including build stages, test automation, artifact management, and deployment strategies.
• Automate infrastructure provisioning and configuration using Infrastructure-as-Code (Terraform, CloudFormation, or similar tools).
• Deploy, and manage AWS cloud infrastructure, including EC2, S3, ECS/EKS, RDS, and networking components.
• Troubleshoot application, infrastructure, and deployment issues, with strong Linux administration and debugging skills.
• Write and maintain automation scripts using Bash, Shell, or Python for deployment and operational tasks.
• Collaborate with Java development teams to embed DevOps practices throughout the software delivery lifecycle.

Claims Specialist

• Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team leader
• Be responsible for meeting productivity targets, financial and procedural accuracy standards as established by management
• Mentor junior members of the team
• Collaborate with other team members on special projects as assigned by the team leads; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by the team leader
• Knowledge base around physician practices and hospital coding, billing and medical terminology, CPT, HCPCS, and ICD-10, UB04, CMS 1500, authorizations, medical terminology, and concepts of healthcare
• Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality

Temporary Claims Processor

Sales

• Focus will be on Core Administration Business-Process-As-A-Service ( BPaaS ), Ecosystem- Platform -As-A-Service ( EPaaS ), Health R ules Payer (HRP) and Provider Data Management (PDM) solutions for Health Plans and Health Insurance Payer accounts (Regional Health Plans)
• Take the lead role in managing the assigned account territory to plan and execute sales strategy to acquire and grow relationships necessary to achieve annual quota
• Manage all phases of the enterprise sales lifecycle including business development, lead identification and qualification, sales strategy, scope construction, proposal development, client presentations and contract negotiations
• Leverage client relationships and detailed knowledge of clients’ commercial processes to ensure predictable execution of deals to achieve new logo revenue goals on an annual basis
• Develop and leverage an in depth understanding of customer needs, industry trends and business and industry priorities, acting as subject matter expert for both internal and external audiences to evangelize HealthEdge solutions and services
• Facilitate the development and presentation of customer-focused demonstrations of HealthEdge solutions, working closely with other required resources and the sales support team as required
• Manage the RFI/RFP process for all BPaaS , EPaaS , HRP an PDM focused RFIs/RFPs in the assigned territory
• Show mastery of HealthEdge’s value proposition and align core offerings to develop and present sales proposals
• Interact with all internal constituents necessary to secure sales, including: product management, professional services, finance and development teams when appropriate
• Report status and activity for all sales pursuits on a weekly basis and keep all opportunities accurate in SalesForce.com
• Participate in all facets of the HealthEdge sales team activities, including sales meetings, forecasting sessions, and companywide events.
• Perform all job functions consistent with HealthEdge policies and procedures, including those which govern handling of PHI and PII

Regional VP, Sales

Claims Processor

Compliance

• Monitor, interpret, and track CMS guidance affecting Medicare Advantage and Medicaid programs
• Communicate state and federal requirements to clients
• Oversee the organization of regulatory distribution process
• Develop desk level procedures, presentations, and training materials

Regulatory Compliance Analyst

Security Engineer

• Contribute to developing and communicating a strategic vision for global security architecture
• Help design and implement comprehensive security architectures encompassing network security, application security, data protection, and identity management
• Identifying and assessing security risks and developing mitigation strategies
• Evaluate and implement advanced security technologies and solutions
• Leverage automation throughout technology stack to ensure best practices with Identity and Access management
• Build bridges throughout the organization, leading with education and building influence

Information Security Architect

• Directly manage a team of Business Consultants, providing day-to-day leadership, guidance, and performance oversight
• Ensure all team members have a clear understanding of client business objectives and the implementation plans in place to achieve them
• Oversee the successful, on-time, and on-budget delivery of software implementation and expansion projects, maintaining a high standard of quality and client satisfaction throughout
• Drive operational efficiency across project delivery by developing and enforcing consistent processes, methodologies, and best practices
• Monitor project timelines, budgets, and resource allocation; identify and address risks before they impact delivery outcomes
• Serve as a strategic partner to client stakeholders and internal Client Operations and Customer Success leaders, ensuring alignment on objectives, priorities, and delivery status throughout the engagement lifecycle
• Act as a primary escalation point for client issues; proactively manage risks and lead corrective action planning with a client-first mindset
• Lead scoping, sizing, and estimating efforts for assigned engagements, and manage competing priorities across the project portfolio
• Coach customers on HealthEdge best practices and advocate for client needs internally to drive the best possible outcomes
• Collaborate cross-functionally with Sales, Product, Customer Success, and other internal teams to ensure alignment on client objectives and delivery requirements
• Provide regular coaching, feedback, and career development support to direct reports; encourage ownership of individual career growth
• Participate in recruiting and employee development activities to build a balanced team with the right mix of skills
• Prepare and present delivery performance metrics, project insights, and status updates to GPS and senior leadership
• Drive continuous improvement initiatives that enhance client satisfaction, delivery quality, and team capability

Manager, Professional Services

Director

• Responsible for the end-to-end delivery of transformation initiatives that improve operational efficiency through technology enablement, product enhancements, and process implementation
• Execute defined transformation priorities by translating strategic objectives into actionable plans and delivering measurable outcomes
• Collaborate with Product, Technology, Operations, and Go-To-Market (GTM) teams to ensure that transformation initiatives improve internal efficiency and enable faster execution
• Coordinate across Product, Technology, Operations, and GTM teams to ensure timely delivery and monitor execution progress
• Support implementation of process improvements designed by the Process Excellence team
• Act as the day-to-day integrator across Product, Technology, Operations, GTM, and Process Excellence teams
• Apply transformation governance standards to assigned initiatives and track progress, risks, dependencies, and KPIs