Business Consultant- HealthRules Payer

1 month ago

Sacramento, United States HealthEdge Software Inc Full time

Overview

Position Overview:

As part of the HealthEdge Professional Services team, theHRPBusiness Consultant is a client-facing role which guides our customers through theirimplementationof our software.This position requires a candidate to perform the responsibilities of a Computer Software/Systems Analyst to include but not limited to creation, redesigning/modification and testing of configured computer software, used to auto-pay healthcare claims.

Responsibilities include requirements gathering, definition, and configuration of the system and workflows for HRP (HealthRulesPayer) customers as necessary. The Business Consulting team drives projects through billable business consulting and advises our customers on optimization of theirHealthRules Payerinstancebased on the analysis of the customer's requirements.

The Consultant will be expected toreview all aspects of animplementationdesign requirementsand undertake system software code changes, quality assurance and testing, documentation ofconfigurationartifacts and occasionally assists with training. Business Consultants also support tier 1 troubleshooting and root cause analysis, along with proof-of-concept configuration to support optimal use of HealthRules Payer.

Your Impact:

  • Serve as a software expert for the customer during their implementation and during SOW projects

  • Responsible for proactively conducting interviews with all stakeholders to elicit detailed functional and system software requirements and managing the requirements throughout the course of the project

  • Assess the current state of the customer's environment

  • Identify and track product gaps

  • Create action item list and issue list

  • Complete business specification stories including acceptance criteria

  • Apply systems analysis techniques and procedures, including consulting with Customer SMEs (system users), to determine software or system functional specifications as pertaining to HRP software

  • Gather and document requirements to design.

  • Based on design requirements, develop/build code related modifications (system configurations) to claims payment computer software, based on user specifications

  • Write HRL (proprietary software application language) statements to program application behavior based on customer business requirements.

  • Design and configure system settings to address the needs of end users, using product specific software code across multiple work streams.

  • Undertaking testing and QA activities to test configuration and functionality

  • Execute manual and automated scripts to carry out functional and regression testing

  • Migrate newly created software protocols for claims payment between customer environments, including promotion to Production environment as part of go-live cutover and testing activities

  • Assist in the preparation and delivery of training materials

  • Work closely to support project members and various project teams

  • Work closely with stakeholders (ie business unit personnel, business experts, other technical staff, vendors, and contractors) to understand and document business and system requirements

  • Responsible for post implementation support as needed including troubleshooting

  • Responsible for ensuring unique customer needs are properly translated into business terms and communicated across all applicable domains

  • Consult with customer to create custom code or enhancement requirements using test-driven development methodology

  • Perform all job functions consistent with HealthEdge policies and procedures, including those which govern handling PHI and PII

What You Bring:

  • 10+ years experience with health plan claims and benefits administration software

  • 3-5 years prior consulting experience in a client facing environment

  • 3-5 years prior experience configuring HealthRules Payer

  • Strong experience with writing the HRL statements and testing

  • Strong business acumen and ability to guide conversations and advise on best practices

  • Strong analytical and problem-solving skills

  • Strong written and verbal communication skills

  • Experience with Jira and Salesforce

  • Job Location: Client site and virtual

  • Travel:Up to 50% travel as needed

  • 4-yearbachelor's degreestrongly desired but can substitute 10+ years of relevant experience

HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace. We aspire to be a place 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 U.S.

Type of Employment: Full-time, permanent

Travel%: Up to 50%

Budget/Revenue Responsibility: None

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 2024-4624

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.

  • Business Consultant- HealthRules Payer

    1 month ago

    Sacramento, California, United States HealthEdge Software Inc Full time

    Overview Position Overview: As part of the HealthEdge Professional Services team, theHRPBusiness Consultant is a client-facing role which guides our customers through theirimplementationof our software.This position requires a candidate to perform the responsibilities of a Computer Software/Systems Analyst to include but not limited to creation,...

  • Business Insurance Consultant

    1 month ago

    Sacramento, California, United States Marsh Full time

    Our not-so-secret sauce.Award-winning, inclusive, Top Workplace culture doesn't happen overnight. It's a result of hard work by extraordinary people. More than 10,000 of the industry's brightest talent drive our efforts to deliver purposeful work and meaningful impact every day. Learn more about what makes us different and how you can thrive as a Business...

  • Senior Business Solutions Consultant

    2 weeks ago

    Sacramento, California, United States SVA Consulting Full time

    Position OverviewA Senior Business Consultant at SVA Consulting operates at the crucial intersection of Business and Technology. This role allows you to cultivate your expertise across various industries, helping you discover your passion and the ideal professional fit.Continuous Learning: Engage in ongoing education through direct client interactions,...

  • Business Intelligence Consultant

    2 weeks ago

    Sacramento, United States West Advanced Technologies Full time

    Position: Business Intelligence Consultant Location: Sacramento, CA (REMOTE) Duration: 12 months Required Skills: Must have a minimum of five (5) years' experience in electronic data processing systems study, design, and programming; at least three (3) years of said experience shall have included responsibility on a project basis for analyzing...

  • Business Banking Consultant

    2 weeks ago

    West Sacramento, California, United States Bank of America Full time

    Small Business Financial AdvisorLocation: West Sacramento, CaliforniaJob Overview:At Bank of America, our mission is to enhance financial well-being through meaningful connections. We prioritize Responsible Growth, ensuring we serve our clients, teammates, communities, and shareholders effectively every day.We are committed to fostering a diverse and...

  • Senior Business Analyst

    3 days ago

    Sacramento, California, United States TalentAmp Full time

    TalentAmp is seeking a highly skilled Senior Business Analyst to join our team in the IT Services and Consulting industry. This 100% remote position is based in Sacramento, CA, and offers a unique opportunity to work with a leading company in the field.**Key Responsibilities:**Elicitation, definition, and documentation of various business, user, and system...

  • Business Analyst

    2 weeks ago

    Sacramento, United States Sabot Consulting Full time

    Job DescriptionJob DescriptionBusiness AnalystLocation: Sacramento, CA Hybrid 2 to 3 days on site. Remote is a possibility.Salary: $80-140kSabot Consulting is currently seeking an experienced Business Analyst with a proven track record in the implementation of IT Service Management (ITSM) and IT Asset Management (ITAM) systems. The Business Analyst will...

  • Workplace Consultant

    3 weeks ago

    Sacramento, United States The Collective Full time

    As a Workplace Consultant, you will work alongside the Sacramento based consultants and account management teams to drive business development for the greater Sacramento marketplace for commercial office furniture.Responsibilities:Develop new client relationships through referrals, networking events, and industry associations. Research and identify new...

  • Workplace Consultant

    3 weeks ago

    Sacramento, United States The Collective Full time

    As a Workplace Consultant, you will work alongside the Sacramento based consultants and account management teams to drive business development for the greater Sacramento marketplace for commercial office furniture.Responsibilities:Develop new client relationships through referrals, networking events, and industry associations. Research and identify new...

  • Medical Program Consultant

    6 days ago

    Sacramento, California, United States Department of Health Care Services Full time

    About this Role:The Department of Health Care Services (DHCS) is seeking a skilled technical program consultant to serve as a Health Program Specialist I (HPS I). This role will provide support to the Division, working independently and as part of multi-division teams to provide consultative services.Key Responsibilities:Perform a variety of tasks to provide...

  • Sales Representative

    3 months ago

    Sacramento, United States CoCard Business Full time

    Job DescriptionJob DescriptionAn exceptional opportunity awaits you to join a leading company in the credit card processing industry with CoCard Business. A national merchant service provider with over a decade of industry experience. Renowned for its pioneering payment processing solutions, CoCard Business presents an all-encompassing package of products...

  • Sales Representative

    3 months ago

    Sacramento, United States CoCard Business Full time

    Job DescriptionJob DescriptionAn exceptional opportunity awaits you to join a leading company in the credit card processing industry with CoCard Business. A national merchant service provider with over a decade of industry experience. Renowned for its pioneering payment processing solutions, CoCard Business presents an all-encompassing package of products...

  • Senior Tax Consultant

    2 weeks ago

    Sacramento, California, United States Jobot Full time

    Remote Senior Tax Consultant - Business Tax Experts with Expanding FirmThis Jobot Job is hosted by: Torey BellA brief overview of our firm:We are a progressive, full-service firm specializing in intricate business taxation. Our commitment to prioritizing our employees not only fosters a positive work environment but also enhances our clients' experiences....

  • ERP Implementation Consultant

    2 weeks ago

    Sacramento, United States Sabot Consulting Full time

    Job DescriptionJob DescriptionERP Implementation ConsultantLocation: Sacramento, CA (Remote)Salary: $90-170kSabot is seeking an experienced and qualified consultant to conduct a comprehensive ERP Implementation Readiness Assessment for an upcoming Enterprise Financial System (EFS) project. This role involves evaluating the current state of the...

  • Store Lead Consultant

    2 months ago

    Sacramento, United States FedEx Office and Print Services Full time

    POSITION SUMMARY: The Lead Consultant is knowledgeable in all areas of the Store's business, including print, signs & graphics, and shipping, and consistently delivers a positive customer experience to all customers. The Lead Consultant's time will be spent taking customer orders; coordinating store activities; providing pricing information; recommending the...

  • Sales Consultant

    1 week ago

    Sacramento, California, United States Bravo Security Services Full time

    Become a Sales Consultant at Bravo Security ServicesAre you an ambitious professional with a keen interest in sales and a background in the security sector? Bravo Security Services is seeking a Sales Consultant to enhance our operations and deliver exceptional client service. If you possess sales expertise and a dedication to quality, we would love to...

  • Customer Service Ambassador

    3 days ago

    Sacramento, California, United States LOCAL BUSINESS FIRM Full time

    Customer Support Representative WantedWe are seeking a highly motivated and ambitious individual to join our team as a Customer Support Representative. This entry-level position offers a unique opportunity for career growth and advancement within our company.Key Responsibilities:Manage customer relationships for small to medium-sized accounts, providing...

  • Senior Tax Consultant

    6 days ago

    Sacramento, California, United States KPMG Full time

    About the RoleKPMG is seeking a highly experienced and skilled Executive Director of Tax Services to join our Closely Held Business/Family Office Tax Services Organization.Key ResponsibilitiesPlay a key role in growing KPMG's Closely Held Business/Family Office tax practice, both locally and on a national level.Serve as the trusted advisor to family offices...

  • Solutions Consultant Healthcare

    2 weeks ago

    Sacramento, United States Palo Alto Networks Full time

    Job Description Your Career The Solutions Consultant is the evolution of the traditional Sales Engineering role, aligning how we best serve our customers in understanding their environment, providing solution guidance and ensuring value realization in their investment with Palo Alto Networks. As a Solutions Consultant you provide technical leadership and...

  • Senior Environmental Consultant

    3 months ago

    Sacramento, United States Trinity Consultants Full time

    Senior Environmental ConsultantLocation: Sacramento, CaliforniaHybrid work scheduleSUMMARYDevelop and maintain high quality client relations through sales, project management and personnel management. Ensure that air quality projects are completed correctly, on time and budget, and that quality projects are made available for the assigned team. ESSENTIAL...