TurningPoint Healthcare Solutions is a leader in advanced clinical and technology-enabled complex condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that enable health plans and employers to improve the safety, quality, and affordability of healthcare. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver optimal care. TurningPoint offers condition-specific, quality-driven, value-based care management services that optimize care from diagnosis and discovery through recovery. TurningPoint’s comprehensive and integrated suite of services enhances the support individuals need, at the time they need it most. Since launching in 2015, TurningPoint has provided support to more than 50 million people nationwide across numerous clinical specialties including musculoskeletal, pain management, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint’s model moves beyond denial-based care to holistic condition management that improves outcomes and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system. Position Summary: Responsible for serving as a key liaison between Operations and Technology, translating business and operational needs into clear system requirements and user stories, supporting prioritization of development work, and coordinating user acceptance testing to ensure technology solutions meet business needs. A strong working knowledge of healthcare claims and claims processing is essential to success in this role. The individual must understand the healthcare claims lifecycle and be able to apply that knowledge when evaluating business requirements, identifying system impacts, developing user stories, supporting testing, and troubleshooting issues. The ability to understand how technology and system changes may impact claims processing, workflows, payment outcomes, and downstream operations is a critical component of the position. This position requires a self-starter with a passion for technology, strong healthcare industry knowledge, and the ability to translate complex operational needs into actionable technology requirements. The successful candidate must be comfortable working in a fast-paced, dynamic environment and balancing multiple competing priorities.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Job Type
Full-time
Career Level
Mid Level