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HealthEdge

Core administrative systems for health plans

Integration Lead

Implementation & Technical Account ManagementConfirmed live in the last 24 hours
Full-timeRemote in USA$130k - $150k /yr

About the Job

Requirements

  • A bachelor's degree or higher in business or a technical field is required.
  • At least 12 years of relevant work experience in technology integrations is required.
  • At least 7 years of work experience in technical leadership roles is required.
  • Knowledge of the healthcare insurance domain, including Medicare Advantage, Medicaid, or Commercial insurance, is required.
  • Experience with people management, mentorship, and creating inclusive and diverse teams is required.
  • Experience integrating EDI healthcare transactions (837, 834, 835, 270/271, 276/277, and 278) with healthcare core administration platforms for claims adjudication or enrollment is required.
  • Experience working in an AWS cloud environment and with AWS cloud services is required.
  • Experience working in an onshore/offshore model is required.
  • Awareness of Agile tools and methodologies is required.
  • Understanding of SQL, Core Java, Spring Boot, Web Services, XML, JSON, Middleware, and CI/CD pipeline principles is required.
  • The role requires communicating technical information effectively with peers, customers, and partners.
  • The role requires the ability to prioritize needs and create scalable processes and structure in a dynamic, sometimes ambiguous environment.
  • The role requires an affinity for leading and navigating change management.
  • The role requires comfort working fully remotely with asynchronous written collaboration and communication.

Responsibilities

  • Design solution technical architecture for customer delivery programs.
  • Integrate Claims, Enrollment, Provider, Authorization, and Payment systems.
  • Ensure compliance with architecture governance.
  • Collaborate with customers, partners, and internal product teams.
  • Identify opportunities for automation, performance improvements, and emerging technologies.
  • Work across multiple time zones in a hybrid or remote work environment.
  • Use video technology for extended periods while working at a computer.
  • Travel as needed, depending on company requirements.

Desired Qualifications

  • Experience with HealthEdge applications such as HealthRules Payor or GuidingCare is a plus.

About the Company

HealthEdge

Core administrative systems for health plans

HealthEdge provides software for healthcare payers, delivering core administrative systems and care-coordination tools for health plans. Its flagship HealthRules Payor uses business rules and workflows to automate claims processing, member services, and provider-network management, integrating with existing payer systems to streamline operations. The company differentiates itself with a 11-year Gartner Sample Vendor recognition, proven claims efficiency, and partnerships like CitiusTech, offering an end-to-end solution that covers licensing, implementation, and ongoing support. Its goal is to help health plans operate more efficiently, improve care coordination, and thrive under value-based reimbursement.

Company size
1,001-5,000
Company stage
Late Stage VC
Total funding
$97.8M
Headquarters
Burlington, MA
Founded
2004

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