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HealthEdge

Core administrative systems for health plans

Healthcare IT Technical Operations Lead

Enterprise ApplicationsConfirmed live in the last 24 hours
Full-timeRemote in USA$90k - $120k /yr

About the Job

Requirements

  • A bachelor's degree in a related field is required.
  • At least 6 years of experience managing a mid- to large-size customer-facing production support environment is required.
  • Strong experience working with healthcare payer platforms such as Facets, QNXT, or NASCO is required.
  • Strong experience with service management, SLA tracking, and operational reporting to customers and management is required.
  • Hands-on experience with EDIFECS/MoveIt is required.
  • Hands-on experience with healthcare EDI, including 270, 271, 276, 277, 834, or 835 transactions, is required.
  • Experience managing the health of production application environments is required.
  • Experience working in a technical support role in a complex architecture environment is required.
  • Experience with SQL is required.
  • Understanding of ITIL practices and software delivery is required.
  • ITIL certification or strong working knowledge of ITIL-based operations is required.
  • Practical knowledge of SOWs, SLAs, and Change Requests is required.
  • Experience in delivery management and customer partner or account interaction is required.
  • Experience working in an onshore/offshore model is required.

Responsibilities

  • Manage operational excellence for technology delivery.
  • Generate SLA and operational reports for customers and management in a timely manner.
  • Drive incident issue resolution and root cause analysis.
  • Manage day-to-day production support for a mid-size health plan, including core administrative systems for enrollments, claims, adjudication, and payments, surrounding applications and products, and downstream and upstream vendors.
  • Address Edifecs and EDI issues in production.
  • Drive customer calls and priorities.
  • Prioritize daily operational events and issues.
  • Manage incidents in service management systems such as JIRA and ServiceNow.
  • Manage change and issue-resolution activities with network, middleware, hardware, operating system, database, and external application groups.
  • Plan system maintenance and upgrade events across multiple vendors.
  • Resolve customer escalations.

Desired Qualifications

  • Experience with Cloud AWS/GCP is desirable.
  • Experience with SOAP is desirable.
  • Experience with ETL processing is desirable.
  • Experience working with SaaS providers and HealthEdge applications 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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