HHAeXchange

Data Analyst

• Analyze Medicaid claims, visit, and billing datasets using SQL and other analytical tools.
• Identify patterns and anomalies that may indicate fraud, waste, or abuse, including: Visit overlaps and impossible or implausible service combinations, Inflated, duplicate, or unbundled billing, Provider billing spikes or outlier utilization patterns, Inconsistencies in electronic visit verification (EVV) data, Suspicious provider enrollment or credentialing indicators, Patterns indicative of upcoding, place-of-service manipulation, or beneficiary identity issues.
• Develop and refine detection queries and analytical logic that can be applied across datasets at scale.
• Conduct proactive data analysis to identify emerging fraud patterns and program integrity risks.
• Apply knowledge of the end-to-end revenue cycle — including claims submission, adjudication, remittance, and denial/appeal workflows — to contextualize billing anomalies and assess their integrity implications.
• Apply machine learning and AI techniques to fraud detection, including anomaly detection models, predictive risk scoring, and unsupervised clustering of suspicious billing behavior.
• Collaborate with data science teams on feature engineering, model validation, and the operationalization of AI-driven detection logic.
• Leverage generative AI and LLM-based tools to support investigation summarization, pattern narrative development, and analytical workflow acceleration.
• Stay current on emerging AI/ML applications in healthcare payment integrity and recommend adoption of relevant tools and techniques.
• Test, validate, and continuously improve fraud detection models and analytical tools as they are developed and refined.
• Translate analytical findings into clear, actionable requirements for product and engineering teams.
• Contribute to the design of fraud detection dashboards, alerting systems, and investigation workflows.
• Support the development of automated detection tools and AI-driven fraud identification capabilities.
• Serve as a subject matter expert on FWA and program integrity concepts to ensure detection logic is clinically and operationally sound.
• Present analytical findings and insights to internal stakeholders and payer clients — including state Medicaid agencies and managed care organizations — in a clear and actionable format.
• Support client discussions related to fraud detection strategy, program integrity reporting, and regulatory compliance obligations.
• Advise payer and state partners on detection methodologies aligned with CMS program integrity expectations, Medicaid Integrity Program (MIP) standards, and applicable federal regulations.
• Document analytical methodologies and investigation approaches to support compliance, audit readiness, and regulatory expectations.

Senior Fraud, Waste, and Abuse Data Analyst

Product Manager

• Contribute to and help execute the product vision and roadmap for HHAeXchange's enterprise data platform.
• Define how core clinical, operational, and financial data is modeled, linked, and surfaced across the product ecosystem.
• Partner with domain PMs (RCM, EHR, Payroll, Payments) to align data structures to real-world workflows and end-user needs.
• Identify opportunities to reduce data fragmentation and improve consistency across product domains.
• Serve as a product champion for AI and machine learning use cases built on the HHAeXchange data platform.
• Define and prioritize data requirements that enable AI-driven features including predictive analytics, anomaly detection, automation, and intelligent recommendations.
• Work with data science and engineering teams to ensure training data quality, feature pipelines, and model outputs are properly governed and trustworthy.
• Evaluate and recommend AI tools, platforms, and frameworks that can accelerate product delivery and enhance the platform's intelligence capabilities.
• Stay current on emerging AI/ML trends in healthcare — including generative AI, LLM applications, and agentic workflows — and translate relevant developments into product opportunities.
• Champion responsible AI practices, including fairness, explainability, and compliance considerations relevant to healthcare data.
• Ensure data models support claims, visits, authorizations, care plans, payroll, and payer rules.
• Translate regulatory, audit, and reimbursement requirements into data standards and traceability.
• Improve data lineage and reconciliation across payer-provider workflows.
• Support the development of a Universal Patient Record that is complete, current, and usable across the platform.
• Collaborate closely with Engineering, Architecture, and Platform teams to shape data services, APIs, and pipelines.
• Write clear product requirements, user stories, and acceptance criteria for data platform features.
• Prioritize data initiatives based on customer impact, revenue risk, compliance needs, and scalability.
• Drive alignment across product teams on shared data definitions, metrics, and reporting standards.
• Support the definition of data ownership, stewardship, and quality standards across product domains.
• Help establish validation, monitoring, and escalation processes for data defects.
• Create visibility into data health for product leaders, operations teams, and stakeholders.
• Contribute to documentation of data standards and governance policies.

Product Manager, Data Management – Platform

QA Automation Engineer

• Architect, build, and optimize end‑to‑end automated customer journeys across in‑app, email, product, and other digital channels.
• Serve as the primary driver of CX automation initiatives within the organization.
• Implement intelligent workflows that personalize experiences at scale (behavioral triggers, segmentation logic, AI‑powered recommendations, etc.).
• Integrate AI tools and models into customer workflows to serve highly-relevant learning content that results in adoption.
• Evaluate and implement new AI and automation capabilities to improve customer onboarding, education, engagement, renewal, and success.
• Own integration strategy across CX, product, and data systems.
• Work hands‑on with tools like Pendo, HubSpot, journey orchestration tools, and data platforms.
• Define success metrics for all digital journeys (activation, adoption, engagement, conversion, retention).
• Analyze journey performance and lead continuous optimization based on data, usage patterns, and customer feedback.
• Partner with Product, Engineering, and Growth Marketing teams to align automation initiatives with product strategy.
• Serve as the “bridge” between technical teams and CX outcomes.

CX Automation Engineer

Solutions Engineer

• Responsible for the coordination, communication, definition, and completion of assigned projects related to the rollout of State and Payer solutions
• Ensure consistency with company strategy, commitments, and goals
• Remove barriers for implementation, customer success, and sales teams for timely implementations
• Maintain impeccable attention to detail and exceptional technical skills
• Engage with customer stakeholders to ensure a positive client experience and engagement
• Participate in cross-functional discussions and strategy sessions
• Support pre-implementation activities including review of implementation requirements and identifying risks
• Represent technical perspectives in client meetings and contribute to decision making

Payer Solutions Architect

• Lead the development of complex product features and initiatives.
• Support development and management of:
• Revenue cycle management products
• Payroll processing solutions
• Drive innovation by identifying and applying emerging AI and automation capabilities to RCM and payroll workflows
• Work with data to identify market trends and customer insights.
• Define and track success metrics (KPIs) for product performance.
• May mentor and support a team of Product Managers to understand market needs and optimize high quality and high value throughput of the product R&D teams.
• Ensure compliance with industry standards.
• Be self-accountable for your product domain’s effectiveness in achieving broader strategic business objectives by formulating and executing product strategies, roadmaps, and release plans.
• Develop a deep understanding of your product’s target markets, features and functionality, limitations, opportunities, buyer/user personas, competitive advantages, threats, etc.
• Conduct regular product roadmap reviews, product demos, and product advisory workshops with internal and external stakeholders.
• Prepare and present new product business cases to senior leadership.
• Partner with Product Management and Technology Leadership on long-term strategic initiative planning and resource alignment.
• Partner with Sales and Marketing in areas such as understanding evolving market needs, ensuring success of campaigns, collaborating on packaging and pricing, assisting with large/complex sales opportunities, etc.
• Partner with Implementation teams to ensure products can be implemented and configured efficiently based on varying market/client needs and help troubleshoot any bottlenecks through product enhancements and/or improved tooling.
• Partner with Support and Client Success teams to facilitate smooth product releases, intake and understand customer feedback, and help troubleshoot product support call drivers.
• Ensure products meet billing compliance standards and support operational efficiency for billing teams, coordinators, and administrators.
• Explore and define how regulatory changes (e.g., CMS, payer policy updates, EVV requirements) create product opportunities and compliance obligations.
• Work with engineering and architecture teams to balance new feature development with technical debt, performance, and security considerations.

Senior Product Manager, RCM

Security Engineer

• Design and guide secure architectures across AWS, Azure, and GCP.
• Define and enforce security baselines aligned with NIST 800-53, HITRUST, and CIS Benchmarks
• Lead threat modeling, architecture reviews, and secure design guidance for cloud workloads
• Build and maintain Infrastructure as Code using Terraform (preferred) and cloud-native tooling
• Integrate automated security controls into CI/CD pipelines (SAST, DAST, IaC scanning, container scanning)
• Implement policy-as-code guardrails using tools such as AWS SCPs and cloud-native governance services
• Develop automated remediation and enforcement workflows to reduce manual security effort
• Embed compliance controls directly into cloud infrastructure and pipelines to support ATO efforts
• Partner with compliance teams and auditors on evidence collection and continuous monitoring
• Implement centralized logging, monitoring, and incident response across cloud environments
• Serve as the senior cloud security SME for engineers, architects, and stakeholders
• Mentor engineers on secure cloud development and DevSecOps practices
• Translate complex security concepts to both technical and non-technical audiences
• Provide daily oversight of security operations, to include the security impact analysis of proposed system modifications and implementations.
• Monitor information security tools, including SIEM, system monitors, access control, and other specific cloud security controls

Principal Cloud Security Engineer

Program Manager

• Accountable for enterprise program management for product-related programs/initiatives
• Nurtures cross-functional organizational alignment and accountability
• Facilitates and drives necessary resource planning and capacity assessments
• Conducts the risk management and scenario planning and develops contingency and/or risk mitigation plans
• Develop, manage, coordinate, and drive program plans for successful product development, and large strategic projects, in collaboration with cross-functional teams
• Viewed as the cross-functional development partner you will facilitate technical discussions and be a thought leader during product reviews and be responsible for designing and executing process which facilitates product-related goal setting, decision making and business impact.
• Develop and manage end-to-end project plans and ensure on-time delivery.
• Track program performance with key metrics and communicate program status to stakeholders, with accountability to drive timelines, deliverables, issues, risks, and dependencies
• Develop strong working relationships and assert influence across departments to manage stakeholder expectations and drive the overall success of large company initiatives
• Partner with project sponsors to define and manage scope, assumptions, and constraints to ensure projects are aligned with business goals and strategies
• Perform risk and change management on all projects
• Responsible for proactive oversight of change management processes to communicate and reset expectations to project scope, schedule, and cost baselines

Senior Program Manager, Solution Coordination

Customer Success Manager

• Oversee a team responsible for driving adoption and supporting the retention of our SMB providers
• Monitor key metrics to evaluate the health of customer relationships
• Help troubleshoot and escalate issues as needed
• Mentor and develop your team to deliver outstanding service to clients
• Inspire and motivate the team to achieve key performance metrics
• Track and measure ongoing client activities to optimize performance
• Provide insightful and actionable feedback from customer and team insights to executive leadership

Manager, Customer Success – SMB

Analyst

• Analyze Medicaid claims, visit, and billing datasets using SQL and other analytical tools.
• Identify patterns and anomalies that may indicate fraud, waste, or abuse, including visit overlaps, inflated or duplicate billing, provider billing spikes, inconsistencies in electronic visit verification (EVV) data, unusual service combinations.
• Develop and refine detection queries and analytical logic that can be applied across datasets.
• Conduct proactive data analysis to identify emerging fraud patterns and potential program integrity risks.
• Translate analytical findings into clear requirements for product and engineering teams.
• Contribute to the design of fraud detection dashboards, alerting systems, and investigation workflows.
• Support the development of automated detection tools and AI-driven fraud identification capabilities.
• Test and validate fraud detection tools and analytics models as they are developed.
• Present analytical findings and insights to internal stakeholders and payer clients in a clear and actionable format.
• Support discussions with states and managed care organizations regarding fraud detection and program integrity.
• Document analytical methodologies and investigation approaches to support compliance and regulatory expectations.

Senior FWA Analyst

Full-stack Engineer

• Provide hands-on technical leadership across our Ruby on Rails platform
• Guide the transition from a single-tenant architecture toward a scalable, multi-tenant model
• Write production Rails code
• Improve infrastructure and delivery workflows
• Raise the bar on reliability, scalability, and execution across teams
• Identify, fix, and improve broken development and operational processes

Lead Software Engineer, RoR

Production Engineer

• Troubleshoot and resolve production incidents across Rails framework services and cloud infrastructure, working from alerts, logs, metrics, and user-reported issues.
• Use interactive application access tools safely and effectively to inspect application state, diagnose issues, and validate fixes.
• Investigate and validate data directly in MySQL/PostgreSQL databases using read-only and controlled write access where appropriate.
• Create and maintain scripts, Rake tasks, and internal tools to streamline incident response, data verification, and operational workflows.
• Assist in incident response, including triage, escalation, documentation, and post-incident follow-ups.
• Collaborate with senior engineers and DevOps to identify root causes and propose long-term fixes.
• Build or enhance internal tools and dashboards that improve visibility into system health, data integrity, and operational risks.
• Monitor system health, key metrics, and operational risks using dashboards and APM tools such as Datadog, New Relic, and CloudWatch.
• Help improve runbooks, documentation, and operational playbooks for recurring issues.
• Gradually contribute to application code changes and bug fixes outside of active incident work.

Production Support Engineer

Manager

• Lead a team of Project Managers responsible for onboarding SMB, mid-market, and enterprise agencies across multiple agency management platforms
• Actively monitor the implementation portfolio, identify risks and deviations from expected progress
• Intervene directly with Project Managers and customers to maintain delivery momentum, protect timelines, and improve adoption outcomes
• Measure success in this role by portfolio health, milestone adherence, reduced implementation abandonment, improved post-go-live retention, and accelerated time-to-value
• Follow HHAeXchange’s hybrid work model, reporting to an office if located within commuting distance of the NYC or Minneapolis Metro office locations (typically 3 days/week)

Manager, Provider Implementation

Learning and Development

• Create and deliver world-class educational content to customers.
• Design innovative learning solutions that drive product adoption, customer retention, and internal enablement efforts.
• Collaborate with Implementation, Customer Success, Technical Customer Care, Product Management, and Product Marketing.
• Develop and implement assessments to measure learning effectiveness.
• Coach and mentor others in adult learning concepts and design principles.
• Increase product and feature adoption and customer retention through educational experiences.

Senior Instructional Designer

Implementation Specialist

• Lead end-to-end Payroll implementations for new and expansion customers, serving as the accountable delivery owner through go-live.
• Define and manage implementation plans, sequencing, milestones, and customer responsibilities to ensure successful activation.
• Facilitate customer discovery sessions to gather requirements, translate business needs into system configuration strategy, and align on execution timelines.
• Coordinate and manage onboarding activities with Payroll partner Salsa, ensuring alignment across all parties and resolving cross-functional dependencies.
• Oversee configuration strategy and validation processes within the platform to ensure accuracy, compliance, and operational readiness prior to go-live.
• Exercise independent judgment to identify delivery risks, adjust project plans, and implement corrective actions to maintain timeline and quality standards.
• Drive structured testing, readiness validation, and activation planning to ensure smooth transition to live Payroll operations.
• Serve as the primary escalation point for Payroll implementation challenges, proactively resolving issues that may impact customer activation or revenue realization.
• Analyze implementation performance trends and recommend strategic improvements to increase efficiency, reduce cycle time, and enhance customer outcomes.
• Partner cross-functionally with Implementation, Sales, Product, Customer Success, and Operations to align expectations, clarify scope, and protect delivery integrity.
• Contribute to refinement of Payroll implementation methodologies and recommend enhancements to leadership based on observed execution patterns.
• Deliver against defined KPIs related to turnaround time, activation success, delivery quality, and customer adoption.

Payroll Implementation Specialist

• Design, build, and maintain high‑performance mobile applications adhering to healthcare security and accessibility standards.
• Own features from concept to release, including design, development, testing, optimization, and regulatory compliance (HIPAA, WCAG).
• Partner with Product, Design, Backend, and QA teams to deliver functional, accessible, and visually polished applications.
• Enforce platform best practices through code reviews, performance optimization, and resolution of bottlenecks and memory or concurrency issues.
• Implement automated testing (unit, UI, integration) and debug complex issues across devices, OS versions, and form factors.
• Own mobile deployment pipelines, leveraging Fastlane and CI/CD workflows to automate testing and distribution.
• Use tools such as CursorAI and GitHub Copilot to improve development velocity and quality.
• Build and maintain secure solutions for sensitive patient data, supporting audits.
• Mentor engineers and drive continuous improvement.