WellSky

Architect

• Translate business segment strategy into functional plans and guide end-to-end execution.
• Evaluate internal functions, business development strategies, and IT processes to promote efficiency, increase security, and support the organization's goals.
• Create and implement business architecture models that reflect the organization's strategies and vision.
• Create methods for compliance architecture, such as data storage, metadata management, and change control.
• Determine and implement build-versus-buy strategies and suggest improvements to reduce costs in alignment with the overall business strategy.
• Provide business architecture to guide projects that follow reference architectures, strategic technology stacks, and standards and best practices.
• Build organizational knowledge of external and internal technical capabilities and trends, facilitate the evaluation of vendors and products, and provide oversight and governance for configuration and implementation of products.
• Establish and document the technology direction and standards for application platforms, including all aspects of software, applications, integration, middleware translators, utilities, tools, and languages for use by information technology groups.
• Apply extensive knowledge of business drivers, technology strategy, and software architecture goals to develop and deliver clear, comprehensive data, technical, and product architectures.
• Leverage AI tools and platforms as an integral part of daily responsibilities to enhance decision-making, streamline workflows, and drive data-informed outcomes.
• Perform other job duties as assigned.

Principal Application Architect

Product Manager

• Validate and specify market requirements by conducting market research supported by visits to clients and non-clients and collaboration with internal stakeholders
• Participate in the development of the solution roadmap and create initiatives and Epics to make roadmap executable
• Translate client requests and market feedback into a design and requirements across a functional domain
• Collaborate with engineering delivery manager by leading conversations to ensure team approach to product development
• Set priorities for development efforts in a domain based on alignment with business goals, strategic direction, voice of the client, timelines, and client commitments
• Assist with planning and execution of go-to market plans
• Serve as cross-functional expert regarding regulatory and accrediting guidelines, healthcare, and market opportunities
• Perform other job duties as assigned

Product Manager – Enterprise Interoperability

Manager

• Cultivate strong, consultative relationships with assigned risk-bearing provider networks to drive engagement and meet client needs.
• Educate and support providers in navigating UM processes, including prior authorizations, medical necessity reviews, and evidence-based care guidelines.
• Serve as a key liaison between providers and the UM team, ensuring clear communication, issue resolution, and ongoing support.
• Act as the in-market expert by managing implementation, education, and continuous engagement for referral benefits and workflows.
• Collaborate with internal teams to execute engagement plans, deliver provider education, and analyze data to identify opportunities for intervention and improvement.
• Serve as an in-market expert, build relationships with key stakeholders, and promote WellSky solutions at clinical summits, town halls, and provider meetings.
• Provide regular updates on provider engagement performance, program feedback, and market insights to internal teams and clients.
• Partner with marketing and operational teams to create educational and promotional materials supporting provider engagement efforts.
• Monitor provider performance and engagement trends, analyzing UM-related data to identify opportunities for intervention, workflow optimization, and improved patient outcomes.
• Perform other job duties as assigned.

Engagement Manager – Provider Network Management

Account Executive

• Identify, define, and qualify new sales opportunities by engaging large-sized prospects and clients
• Strategize selling approaches and revenue growth plans in collaboration with business unit leadership
• Assist with strategic partnerships and sales channels
• Proactively identify market trends and conditions, industry changes, and competitor activities
• Lead complex client relationships and sales processes from inception to closure
• Navigate multiple decision-makers, stakeholders, and effectively lead contract negotiations
• Track the status and activities of all assigned accounts and prospects in Salesforce
• Generate periodic reports upon request related to expected closures
• Achieve quarterly goals related to lead generation, pipeline management and quota attainment

Account Executive – Home Health & Hospice

Medical Billing and Coding

• Manage day-to-day operations of multiple teams
• Ongoing monitoring of productivity, quality, and capacity
• Shape communication with respective agencies and internal teams
• Strategize with the quality team to support ongoing quality programs
• Manage services to ensure appropriate coding practices, regulatory, and contractual compliance
• Provide relevant client metrics through accurate and up-to-date client dashboards
• Determine resolution of complex issues with clients and internal teams
• Perform other job duties as assigned

Senior Manager, Medical Coding

• Identify, define, and qualify complex sales opportunities
• Proactively identify market trends, industry changes, and client needs
• Track, maintain, and report sales pipeline and account activities in Salesforce
• Act as a subject matter expert on assigned clients and deals
• Collaborate with strategic partners and sales channels as needed
• Achieve quarterly goals related to lead generation, pipeline management, and quota attainment

Account Executive – Blood & Biotherapies

Medical Reviewer

• Oversee daily operations of clinical operation support staff and ensure tasks are completed efficiently and accurately
• Serve as the primary point of contact for team communications by promoting collaboration and resolving minor operational challenges
• Assist in the development and execution of work plans, assign tasks, and monitor completion to meet team goals
• Provide direct support and guidance to team members, including on-the-job training and resource allocation
• Ensure compliance with organizational policies and maintain accurate documentation of team activities
• Monitor team performance metrics to identify areas for improvement and ensure quality service delivery
• Perform other job duties as assigned

Team Lead, Authorization Management Clinical Reviewer

Consultant

• Collaborate with project teams to complete implementation tasks, including gathering requirements, analyzing clinical workflows, and identification of workflow challenges.
• Engage with providers to review requests and offer recommendations based on proficient knowledge of clinical workflows that will ultimately enhance patient care, treatment plans, and health outcomes.
• Provide hands-on training to designated clients while guiding them through the solution's functionalities and features to increase proficiency in utilization.
• Use industry compliance knowledge and follow established practices and guidelines to ensure the implementation of clinical solutions complies with regulations and standards.
• Review a variety of factors for solution configurations, understand solution functionalities, and troubleshoot technical issues to offer consultation and support.
• Perform other job duties as assigned.

Clinical Consultant II

• Review acute and post-acute authorizations for medical necessity using InterQual guidelines
• Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care
• Participate in team meetings, educational activities, and interrater reliability testing to maintain review consistency and professional growth
• Ensure compliance with federal, state, and accreditation standards, and identify opportunities to enhance communication or processes
• Utilize knowledge of resources available in the healthcare system to assist physicians and patients effectively
• Perform other job duties as assigned