Full-Time
Core administrative systems for health plans
No salary listed
Chennai, Tamil Nadu, India
In Person
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HealthEdge provides software for healthcare payers, delivering core administrative systems and care coordination tools for health plans. HealthRules Payor, its flagship claims processing system, automates claims, member services, and provider network management by applying business rules and workflows and by integrating with existing payer systems. The company distinguishes itself with a 11-year Gartner Sample Vendor recognition for core administrative systems, a track record in efficient claims processing, and partnerships like CitiusTech that expand capabilities, along with an end-to-end suite that combines licensing, implementation services, and ongoing support. HealthEdge aims to help health plans run more efficiently, improve care coordination, and succeed in value-based care by providing scalable, integrated administrative and care-management solutions.
Company Size
1,001-5,000
Company Stage
Late Stage VC
Total Funding
$97.8M
Headquarters
Burlington, Massachusetts
Founded
2004
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Flexible Work Hours
Remote Work Options
Hybrid Work Options
HealthEdge(R) expands India footprint with new Thiruvananthapuram campus, deepening commitment to technology innovation and growth in Kerala. Thursday, Aug 20, 2026 17:25:24 | HealthEdge Thiruvananthapuram, Kerala, India - Business Wire India HealthEdge(R), a leading healthcare technology company serving more than 110 million covered lives across the United States, today inaugurated its new campus at Brigade Square, Technopark in Thiruvananthapuram. The expansion reinforces HealthEdge's long-term investment in India and marks the next chapter of a deep and established presence in Kerala. HealthEdge provides AI-powered software and technology-enabled services that help U.S. health plans modernize healthcare administration, bringing together operational services with payer claims administration, payment accuracy, care management, risk adjustment, and provider data management technologies. Following HealthEdge and UST HealthProof's merger, the two organizations have united under a single HealthEdge brand, backed by Bain Capital. For Kerala, this is not a new relationship - UST HealthProof has had a longstanding presence in the state, and this campus marks its evolution under the HealthEdge brand. "Thiruvananthapuram has emerged as one of India's most compelling destinations for global technology companies, and this campus reflects our long-term commitment to the city," said Kevin Adams, CEO of HealthEdge. "The people who work here are central to how we build and deliver our platform. We're proud to be part of what's growing in this community. As HealthEdge continues to grow in India and across our global geographies, including the United States, the Philippines, and Mexico, we are actively recruiting talented professionals to join our teams." The new campus spans approximately 162,000 sq. ft. across 11 of Brigade Square's 12 floors, with seating capacity for approximately 1,500 employees. HealthEdge operates across seven cities in India: Chennai, Coimbatore, Bangalore, Hyderabad, Pune, Kochi, and Thiruvananthapuram, with teams spanning engineering, product development, technology, operations, and corporate functions. To learn more about career opportunities, follow HealthEdge on LinkedIn and visit HealthEdge.com/careers. About HealthEdge HealthEdge(R) 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 HealthEdge.com. (Disclaimer: The above press release comes to you under an arrangement with Business Wire India. PTI takes no editorial responsibility for the same.)
Frazier Healthcare Partners names Stephen Krupa as exec in residence for buyout team Most recently, Krupa served as CEO of HealthEdge from 2016 to 2025. 1 hour ago
CMS awards companies nearly $2 billion to modernize Medicare claims. CMS awarded information technology companies HealthEdge Software and Peraton contracts totaling almost $2 billion to replace four legacy Medicare claims adjudication systems with a new cloud-based system, a major tech initiative the Trump administration unveiled earlier this year and expects to be done within three years. Not a subscriber? Sign up for 30 days free access to exclusive, detailed reporting on drug pricing reforms, Medicaid policy, FDA news and much more. NEWSLETTERS Inside Health Policy is a subscription-fee-based daily digital news service from Inside Washington Publishers. SITE LICENSES Economical site license packages are available to fit any size organization, from a few people at one location to company-wide access. For more information on how you can get greater access to Inside Health Policy for your office, contact Online Customer Service at 703-416-8505 or [email protected]. STAY CONNECTED (C) 2002-2026. Inside Washington Publishers | Contact Us
HealthEdge has partnered with Ellipsis Health to integrate AI-powered virtual nursing into its Care Solutions suite. The collaboration brings Ellipsis Health's AI care management voice agent, Sage, to health plans seeking to scale member outreach whilst addressing clinical workforce shortages. Sage conducts autonomous phone conversations with members for high-volume outreach tasks including health risk assessments, post-discharge follow-ups, risk profiling and care gap closure. The system integrates with HealthEdge's GuidingCare platform, drawing on member data to personalise conversations and feeding outcomes back into the platform. Powered by Ellipsis Health's patented Empathy Engine, Sage analyses vocal cues in real time to assess emotional signals and adapt responses. The technology allows health plans to automate routine outreach, enabling nursing teams to focus on complex, high-touch interventions requiring clinical expertise.
HealthEdge has launched the GuidingCare Decision Intelligence Ecosystem, integrating three clinical AI vendors — Anterior, Latitude Health and Case Health AI — to transform utilisation management for health plans. The ecosystem enables health plans to select best-in-class AI solutions whilst using GuidingCare's care and utilisation management platform. Prior authorisation accounts for $35 billion annually in administrative spending, with 94% of patients experiencing care delays. The ecosystem addresses these challenges through seamless API integration, allowing UM nurses to leverage AI decision support tools without workflow disruption. The inaugural vendors deliver significant results: Anterior achieves 99.24% clinical accuracy with 74% reduction in review times, Latitude Health delivers over 3x greater review throughput, and Case Health AI cuts decision times by up to 75% whilst maintaining over 99.6% accuracy.