H

HealthEdge

Core administrative systems for health plans

Senior Customer Success Executive

Customer SuccessConfirmed live in the last 24 hours
Full-timeRemote in USA$146k - $179k /yr

About the Job

Requirements

  • 10+ years in health plan operations, healthcare consulting, or healthcare technology/services, serving or operating within enterprises of $1B+ revenue or equivalent-scale health plans.
  • Demonstrated ownership of customer outcomes through difficulty, such as turnarounds, escalations, or at-risk retention, with accountability for measurable customer-health, retention, or renewal targets.
  • Proven ability to deliver outcomes through teams the candidate did not manage.
  • In-depth knowledge of health plan operations end to end, including claims, enrollment, billing, provider/network data, utilization management, and the regulatory environment, including CMS and state programs.
  • Commercial fluency in contracting, vendor dynamics, and SLA structures.
  • Ability to run a distressed account back to health as a managed program, including establishing the operating rhythm, sequencing the recovery, and de-escalating an executive relationship without over-promising.
  • Demonstrated project or workstream management through completion, with named owners, dates, and dependencies.
  • Deep experience with at least one enterprise-class core administration or payer platform, such as Facets, QNXT, HealthRules Payer, or a comparable system.
  • If HealthEdge product experience is absent, working fluency in the HRP suite is expected within 6 months.
  • Proven experience driving adoption of new technology in a commercial software environment.
  • Fluency with modern work tools, including AI tools such as Claude, as a daily working practice.

Responsibilities

  • Create and own a Customer Success Plan for every assigned customer account, tied to the customer's business objectives rather than HealthEdge's delivery milestones.
  • Coordinate execution across Delivery, Operations, Technology, and Product, and own customer outcomes even when others own the tasks.
  • Translate HealthEdge platform capabilities into language, evidence, and outcome metrics relevant to customer executives.
  • Identify account risk proactively, act on it, and resolve issues before customers raise them.
  • Own a Path to Green plan for every at-risk account, with named owners, dated milestones, and measurable outcomes.
  • Build and execute plans to convert satisfied customers into active advocates and references.
  • Identify multi-product and cross-sell opportunities tied to customers' strategic direction and target business outcomes.
  • Partner with Sales to hand off expansion opportunities cleanly.
  • Maintain a current view of each customer's strategic roadmap and commercial architecture, including contract terms, SLAs, pricing mechanics, and renewal dates, and provide commercial framing during escalations.
  • Keep health scoring, CRM records, and success plans accurate, complete, current, and audit-ready.
  • Contribute to consolidated reporting that provides leadership with a trusted single source of truth.
  • Proactively flag data gaps or health-score discrepancies before they cause reporting surprises.
  • In the first 90 days, assess all assigned accounts, including each account's outcome case, health score, and risk register.
  • In the first 90 days, identify the two or three accounts with the highest churn or expansion risk and develop a preliminary Path to Green for each.
  • In the first 90 days, build working relationships with internal counterparts in Delivery, Operations, Product, Technology, and Sales.
  • At 12 months, improve portfolio retention rate and health scores.
  • At 12 months, convert at least one at-risk account to referenceable status.
  • At 12 months, identify and hand off one or more expansion opportunities to Sales with clear commercial framing.
  • At 12 months, keep portfolio data accurate, current, and audit-ready.
  • At 12 months, support or manage CSEs so they operate independently without requiring gap-filling.
  • At 12 months, demonstrate a consistent behavior profile confirmed by CSE leadership calibration feedback.
  • Work across multiple time zones in a remote or hybrid work environment.
  • Use video technology during long periods of computer-based work.
  • Travel as required by company needs.

Desired Qualifications

  • BPaaS or managed-services delivery experience is strongly preferred.
  • Executive or senior-leadership role in a healthcare environment.
  • Experience on the health-plan side of a vendor relationship, having been the customer.
  • Experience in a private-equity-backed, transformation, or turnaround environment.
  • HealthEdge product suite experience.
  • Hands-on exposure to a system implementation, platform migration, or major upgrade from any seat, including testing, data conversion, cutover support, training, or PMO.

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

Recently Posted Jobs

Explore more opportunities at HealthEdge

See more jobs