HealthEdge · 13 hours ago
Business Consultant - HRP
United States
Full-time
Remote
Mid, Senior Level
$91K/yr - $125K/yr
5+ years expHealthEdge is a company focused on healthcare solutions, and they are seeking a Business Consultant to drive the successful implementation and optimization of healthcare claims software solutions for clients. The role involves high-level client engagement, project support, solution design, and quality assurance, while ensuring alignment with client objectives and timelines.
Enterprise SoftwareHealth CareProduct DesignSoftware
Responsibilities
Support the end-to-end healthcare claims software implementation projects, within assigned Value Stream, ensuring alignment with client objectives and timelines. Collaborate with other team members within the assigned value stream
Engaging with clients, to build strong relationships and ensuring client satisfaction within the assigned responsibilities
Collaborate with clients to understand their needs and support the design of tailored software solutions that meet their business requirements within the assigned Value Stream. This involves configuration of HealthRules Payor and related solutions
Identify potential project risks and develop mitigation strategies to ensure project success. Proactively monitor risks throughout the project to ensure successful outcomes
Ensure that all deliverables meet the highest standards of quality and compliance with industry regulations
Stay current with healthcare industry trends and best practices, continuously seeking opportunities to improve our implementation processes
Support the assessment of the client's current business requirements, based on the value streams, Plan Management, Provider Management, Member Management, Claims Management, Customer Service, and User Security
Coordinate and lead activities with customers, third-party vendors, and HealthEdge internal stakeholders as directed in the assigned Value Stream
Consult on optimization and troubleshooting HealthRules Payer functionality
Aid clients with capturing defects, performing initial triage, tracking and re-testing remediation
Be prescriptive in consultation of recommendations in requirements and solutions, while always maintaining a customer-centric mentality
Subject Matter Expert in (1) Value Stream
Participates in process optimization efforts within the Consulting Services organization and in assigned Value Streams
Familiarize and adhere to the role-specific documentation and training materials in support of Value Stream initiatives
Perform all job functions consistent with HealthEdge policies and procedures, including those which govern the handling of PHI and PII
Familiarize and adhere to playbooks
Responsible for identifying functional gaps within HealthRules Payer Suite
Support the customer in creation of requirement documents needed when they are requesting an enhancement or new feature
Digital Planner, timelines and estimates for Business tasks within the implementation statement of work for the assigned Value Stream
Maintain delivery timeline and quality attributes using approved processing tools
Oversees Business backlog, including issues and requirements, within assigned Value Stream
Leads completion of the Business transition to support artifacts for their assigned Value Stream
Other duties as assigned
Qualification
Required
Bachelor's degree in related field
5 years of experience in a customer-facing, business consulting/product implementation/business analysis role
5 years prior health plan industry (HMO, PPO, POS, MAPD, Medicare, Medicaid, Dental etc.) experience
5 years prior Business Consulting/Analyst experience
5 years prior ITS/BlueCard experience a plus
Experience with Health Plan Claims and Benefits administration Software
Excellent written and verbal communications skills
Ability to remain calm in challenging situations
Ability to work in a fast-paced environment
Ability to communicate change within a project
hands-on experience using HealthRules Payer Suite Prior experience with Health Plan core system implementation
Ability to work under pressure, react and manage change
Manage Conflict and facilitate resolution to client issues
Dealing with ambiguity while guiding customers
Company
HealthEdge
HealthEdge Software offers benefits administration and care management software solutions.
1001-5000 employees
H1B Sponsorship
HealthEdge has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (45)
2024 (37)
2023 (35)
2022 (56)
2021 (35)
2020 (34)
Funding
Current Stage
Late StageTotal Funding
$97.78MKey Investors
MedicaOaktree Specialty LendingPsilos Group
2025-04-08Acquired
2020-03-09Private Equity
2017-07-14Series Unknown· $34M
Leadership Team
A
Alex Saltzman
Chief of Staff to the CEO & Senior Vice President of Corporate Development
Kevin Adams
Chief Executive Officer
Recent News
2025-12-06
Precedence Research
2025-11-21
2025-11-07
Company data provided by crunchbase