Director, Configuration Implementation
About The Position
About HealthEdge HealthEdge® is trusted to provide the technology and services that power health plans’ most important value streams. With an integrated platform of solutions spanning claims administration, quality improvement, prospective payment accuracy, provider network management, care management, member engagement and risk adjustment, HealthEdge enables health plans to converge their data so they can harness automation and the promise of AI. Combining this next-gen technology with services and expertise gives health plans unmatched capabilities to deliver a future of frictionless and cost-effective healthcare experiences. For more information, visit www.HealthEdge.com. Position Overview: The Director, Configuration Implementation is responsible for managing multiple implementation teams, ensuring alignment with project objectives and client expectations. The selected candidate will monitor progress, provide strategic feedback, and address key issues. This individual will also cultivate client relationships, drive successful project outcomes, and ensure seamless transitions to support teams.
Requirements
- Bachelor’s degree in computer science, Business Administration, Healthcare Administration, or related field preferred
- Must have Leadership and Mentorship experience
- Minimum of 8 years hands-on HealthRules Payor configuration experience
- High proficiency in multiple HealthRules Payor components including but not limited to Pricing, Benefits, Claims, Utilization Management.
- Minimum of 10 years total experience in healthcare claims processing or health plan operations
- Proficiency in one or more third party claims pricers and/or claims editing solutions
- Proven track record of successful large-scale HealthRules Payor implementations
- Must have experience working with customers
- Previous consulting experience
Responsibilities
- Lead customer discovery sessions and requirement workshops with health plan stakeholders
- Support sales cycles including but not limited to RFP responses, Statement of Work and proof-of concept development
- Develop resource (FTE) estimates and financial projections for implementation
- Lead, mentor and supervise multiple implementation teams, ensuring alignment with project goals and client expectations
- Monitor the progress of implementation projects to ensure the teams meet critical milestones and deliverables
- Establish and cultivate strong relationships with client leadership to drive successful project outcomes and serve as a primary point of escalation when necessary
- Provide guidance to teams on the product and deliver effective solutions to complex issues, ensuring timely problem resolution
- Spearhead innovation by architecting process solutions across HealthRules Payor modules to develop scalable, reusable configuration accelerators
- Evaluate post-implementation reviews to assess project success and identify opportunities for continuous improvement
- Support the transition of all implementation projects to the ongoing support teams, ensuring a seamless handover and continued support
- Collaborate with cross-functional teams to enhance configuration outcomes and drive continuous improvement
- Should be flexible in work roles and hours
- Must be able to travel
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What This Job Offers
Job Type
Full-time
Career Level
Manager
