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HealthEdge

Core administrative systems for health plans

Data Conversion Lead

Data EngineeringPosted on Nov 5
Full-timeRemote in USA$150k - $170k /yr

About the Job

Requirements

  • At least 4 years of experience working with healthcare payer data domains, including Claims, Enrollment, or Provider.
  • A bachelor's degree or higher in a Business or Technical field.
  • At least 12 years of experience in technology integrations, including at least 7 years in technical leadership roles.
  • Hands-on experience leading data conversion or data migration projects, including mock, parallel, and full-volume execution phases.
  • Experience designing and implementing ETL processes across extract, transform, and load phases.
  • Experience using SQL for data extraction, validation, transformation, and profiling, with SQL Server or an equivalent.
  • Experience working in an onshore/offshore delivery model.
  • Experience using Python to extract data and automate conversion routines.
  • Experience with bulk data loading.
  • Experience working with a team of onshore/offshore technical resources.
  • Ability to present conversion status, risks, and results clearly to clients and senior management.

Responsibilities

  • Lead and manage end-to-end conversion of healthcare payer data between platforms, such as legacy systems and HealthRules Payer or GuidingCare.
  • Serve as a subject matter expert for payer data domains, including Claims, Enrollment, Provider, and Authorizations, and their data structures, relationships, and business rules.
  • Analyze healthcare payer data patterns, perform data profiling, and define transformation and mapping rules for migration from source to target platforms.
  • Design and execute phased conversion plans covering mock runs, parallel runs, and full-volume loads, while setting timelines and client expectations.
  • Lead workflow and gap-analysis sessions, identify data discrepancies, and define resolution strategies.
  • Write, maintain, and unit-test data-conversion code in Python and SQL based on documented transformation logic of limited to moderate complexity.
  • Design ETL processes, including data extracts, load logic, stored procedures, workflows, and data mappings.
  • Enforce naming standards and maintain data dictionaries and documentation for conversion data models.
  • Conduct post-installation testing and identify and correct conversion defects before go-live.
  • Plan and conduct client and user review sessions on conversion results, and implement corrections based on feedback.
  • Communicate conversion progress, risks, and issue resolution to clients.
  • Develop documentation for conversions, including transformation rules, mapping specifications, profiling findings, and validation reports.
  • Collaborate with project managers, business teams, and cross-functional stakeholders across onshore and offshore teams.
  • Mentor and guide junior team members on conversion processes, best practices, and technical standards.
  • Develop and contribute to reusable conversion assets, accelerators, and knowledge repositories.

Desired Qualifications

  • Experience architecting software or data solutions and applying architecture governance principles.
  • Experience with HealthRules Payer or similar platforms.
  • Experience with Medicare or Medicaid programs, including CMS data structures and compliance requirements.
  • Experience with EDI transaction processing, including 837P and 837I claims transactions and 834 enrollment transactions.
  • Experience with ETL tools such as Informatica, Talend, or equivalent platforms.
  • Experience with BI or reporting tools such as MicroStrategy, Power BI, or equivalent.
  • Exposure to AWS, Azure, or GCP cloud platforms; Architect or Big Data certification.
  • Knowledge of data visualization tools and dashboard design.
  • Familiarity with backup, archival, and data recovery specifications.

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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