Job Description

HealthEdge Software Inc Team Lead - Business Consultant Juneau, Alaska Apply Now The Business Consultant Team Lead plays a pivotal role in providing strategic guidance and expertise to our clients to help them achieve their business objectives specific to configuration set up within Source. You will lead a team of business consultants and Configuration Analysts to drive growth and transformation of our clients through the Source application. The Business Consultant Team Lead will have in-depth and comprehensive subject matter expertise in Source products related to implementation/consulting engagements, strategic user adoption initiatives, and ongoing client support. The Product: With Source , we’re changing the industry narrative, providing a more holistic approach to payment integrity that focuses on comprehensive reimbursement, agile editing, and integrated analytics. Our interoperable, cloud-based solution is modular to meet a health plan’s needs today and extensible to grow with their organization over time—bringing disparate parts of a payer’s organization together for improved accuracy and insights. The Source platform offers the ability for clients to unlock transformation at the reimbursement, payment integrity, and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity Transformation includes rich editing libraries with history-based capabilities, easy development of customized edits, and improved transparency to reduce vendor dependency and increase control. As a complete solution, clients can achieve Enterprise Transformation, where root-cause issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite of solutions from HealthEdge delivers a digital foundation for payers specifically designed to fuel a digital transformation, reduce costs, and improve both clinical outcomes and the member experience. Your Impact: Contribute to business development efforts, including participating in perspective client presentations, demonstrating Source product capabilities using use-case scenarios, and gathering preliminary client information. Analyze, design, and configure complex client requirements. Conduct comprehensive assessments of client businesses, including analyzing processes, identifying inefficiencies, and recommending Source solutions. Collaborate with the sales team on SOW development to define project objectives, scope, and deliverables, ensuring alignment with client and business goals. Act as a liaison and escalation point between clients, sales, and our implementation teams to ensure delivery of high-quality solutions that meet client expectations. Foster strong client relationships through effective communication, stakeholder management, and value-driven consulting services. Provide SME education on all aspects of Source features/functionality to Source end-users, actively managing and/or participating in the development, maintenance, and execution of client-facing education services. Serve as an escalation point for critical client needs; lead diagnosis and resolution of escalated client issues and act as a liaison between clients and internal support teams to assure accurate problem identification and resolution. Mentor and coach more junior consultants, providing guidance and support to help them develop their skills and capabilities. What You Bring: 12 or more years’ experience working in consultancy, client operations, project management, or related roles within the SaaS industry. 7 or more years’ experience within the Healthcare industry; direct experience within a Health Plan, TPA, or provider strongly preferred. Experience leading a team in the healthcare industry. Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care, and commercial payment methodologies, payment integrity, and health plan operations (e.g., claim life cycle/workflows, network contracting, payment/policy related configuration, provider relations, medical management, medical economics, audit, compliance). Experience with interpretation/translation of complex health-plan in-network and out-of-network provider rate and/or claim editing provisions. Experience with configuration and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. Working knowledge of claim billing specifications (e.g., CMS-1500, UB-04, 837, HIPAA code sets). Creative problem-solving skills including the ability to identify, recommend, and implement strategic solutions. Highly collaborative and adaptable, with a proactive approach to problem-solving and decision-making. Strong analytical skills, with the ability to synthesize complex information and develop actionable insights. Excellent communication and interpersonal skills, with the ability to build rapport with clients and influence key stakeholders. Bachelor's degree in Business Administration, Information Technology, or related field. AHIP, HFMA, AAPC, and/or AHIMA certification strongly preferred. HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace where all employees have the opportunity to belong, make an impact, and deliver excellent software and services to our customers. Geographic Responsibility: While HealthEdge is located in Burlington, MA you may live anywhere in the US. Type of Employment: Full-time, permanent Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus. Work across multiple time zones in a hybrid or remote work environment. Long periods of time sitting and/or standing in front of a computer using video technology. May require travel dependent on company needs. The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check. HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans, and persons with disabilities. Job Locations: US-Remote

ID: 2025-6190

Category: Professional Services Position Type: Full-Time HealthEdge provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr HealthEdge Software Inc

Job Tags

Permanent employment, Full time, Contract work, Local area, Remote job, Flexible hours,

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