Compensation Overview

Position Summary:

MacroHealth has an exciting opportunity for an experienced Healthcare Implementation Consultant to join our team and help us bring a transformational solution to life for our healthcare customers. Using your significant healthcare Payer operations experience, you will act as a trusted advisor to MacroHealth clients and partners to accelerate their ability to implement new network/vendor relationships that add value to our clients and their constituents. Your detailed understanding of US Healthcare Payers, specifically enrollment, claims, pricing and clinical operations will make you a natural for this role. Among other duties, you will be responsible for defining and gathering healthcare operations related requirements to drive development of EDI, JSON and other types of application configuration. 

Key Relationships: Healthcare payers and Production Activations

Key Accountabilities: 

• Works closely with healthcare payers and provider networks to understand their operational requirements, allowing the creation of data exchange specifications to support healthcare data transformations 
• Documents client requirements and collaborates with team members to develop solutions that meet client-specific business needs 
• Translates client’s business requirements into application configuration, workflows, business processes, and facilitates technical specifications 
• Leads clients through design and deployment of technical solutions 
• Creates and maintains implementation related documentation, such as business and functional requirements, process flows and configuration worksheets 
• Collaborates with other implementation team members and teams across MacroHealth to identify and develop solutions that deliver exceptional client value 
• Assist with the continuous improvement of implementation and service delivery best practices, processes, and tools 
• Communicates clearly and explains technical concepts in layman’s terms so that a non-technical audience can clearly understand what is needed for flawless implementations 
• Advocates for and evangelizes "best practices" to ensure long term success and value for MacroHealth and our clients 
• Builds and manages relationships at multiple levels of client organizations, from frontline staff to C-suite stakeholders 
• Collaborates with external client teams to understand evolving requirements/needs and communicate potential approaches to address them 
• Acts as a “trusted advisor” by payers and networks

Knowledge, Skills and Abilities:

• A working knowledge of general healthcare IT and data exchange (EDI) operations
• Proven success in working with a team to collectively define, isolate, analyze, comprehend and solve complex issues 
• Empathy and a passion for problem solving 
• Outstanding planning, negotiating, and influencing skills 
• Ability to effectively prioritize and execute tasks while working both independently and in a team-oriented, collaborative environment
• Strong interpersonal skills including excellent written and verbal communication skills; listening and critical thinking; presentation and facilitation skills 
• Ability to develop strong working relationships with stakeholder groups, both internally and externally at any functional level 
• Outstanding task management skills across a varied set of responsibilities 
• Ability to thrive in a fast-paced, start-up environment 
• Serve as a role model of flexibility during organizational and/or business changes

Required Education and Experience:

• 6 + years’ experience in health plan operations (can speak to how a health plan/payer operates), especially enrollment, utilization management, and claims pricing, processing and payment functions 
• 5 + years’ progressive client-facing implementation or operations experience 
• Big five consulting experience within healthcare payer industry 
• BA/BS degree in information technology, business, healthcare administration or related discipline. MS in Healthcare Administration, Business or other related degree (nice to have)
• Background in implementation of software as a service (SaaS) products
• EDI technical expertise especially with ANSI X12 834, 837 and 835 transactions (nice to have)

Travel: Up to 25% of the time  

Salary: $110,000 - $125,000 DOE

Core Competencies:

One Team: 

Act as one team with fellow MacroMates and customers 

Value humility, low ego, and collaboration 

Maintain an All for One, One for All attitude  

Deliver on Promises: 

Do the right thing 

Do what you say you will do 

Work with a sense of urgency and transparency

Macro Thinking:  

Challenge yourself and others to think boldly, bigger, and into the future 

Lead with a Growth Mindset 

Act as a thought leader for the healthcare industry