HealthEdge

Engineer

• Monitor, triage, and resolve customer production service requests across priority levels
• Ensure compliance with response and resolution timeframes and prevent SLA breaches
• Perform real-time incident analysis and provide status updates to customers and stakeholders
• Coordinate emergency production fixes and hotfixes with development and infrastructure teams
• Conduct root cause analysis for critical and high-priority production issues
• Investigate intermittent and non-reproducible issues using logs, audit tables, and environment analysis
• Perform technical investigations across application, database, and configuration layers
• Analyze application logs, error traces, and stack traces
• Provide investigation findings and code snippets to development teams
• Write and execute complex SQL queries for investigation and data analysis
• Perform backend data corrections, migrations, and cleanup
• Manage data correction scripts through CAB approval and change management
• Support application configurations across QA, UAT, Training, and Production environments
• Handle configuration synchronization, user provisioning, access management, and role-based permissions
• Act as the primary escalation point from L1 for complex production issues
• Manage GCPROD tickets with the Product team
• Collaborate with CFT, DBA, Product, Infrastructure, and DevOps teams
• Serve as the direct point of contact for enterprise customers
• Communicate incident status and resolution findings professionally
• Participate in and initiate customer calls and demonstrations
• Identify and drive automation initiatives
• Develop automation scripts for routine data corrections and validations
• Implement process improvements to reduce ticket volume and resolution time
• Build monitoring and alerting mechanisms for proactive issue detection

Technical Services Engineer

• Provide ongoing support for ETL pipelines processing large healthcare datasets
• Analyze production issues, implement code fixes, troubleshoot technical problems, and deliver immediate solutions
• Collaborate with customers to diagnose and resolve software-related issues
• Deploy, orchestrate, and monitor jobs across environments
• Create process documentation, architecture diagrams, and deployment guides
• Identify opportunities for process improvements
• Participate in team meetings and scrum activities
• Interface with developers, business analysts, delivery managers, QA teams, project managers, and account managers
• Use JIRA for issue tracking and resolution
• Seek stakeholder feedback to improve skills and adapt processes
• Provide occasional weekend support for critical issues

Senior Technical Services Engineer

• Provide first-line product and technical support to customers
• Diagnose customer issues, research solutions, and resolve tickets within established SLA guidelines
• Troubleshoot technical problems through systematic analysis
• Collaborate cross-functionally to identify root causes and implement effective solutions
• Triage and prioritize customer issues
• Deliver timely workarounds and guide users on best practices and preventive measures
• Escalate complex issues appropriately while maintaining clear customer communication
• Contribute to knowledge base documentation
• Develop reusable scripts to improve team efficiency and customer self-service capabilities
• Maintain flexible availability to support customers across time zones, including occasional early morning or evening shifts for US team collaboration
• Participate in mobbing sessions and team learning activities
• Identify and update missing or inaccurate documentation
• Adapt to new tools and processes
• Communicate clearly with customers and document next steps effectively

Associate Technical Services Engineer

Risk

• Help sales and CSEs build and maintain relationships with key decision-makers
• Understand client needs and align current and future solutions with strategic goals
• Assist in developing and executing market-specific sales plans using market insights and competitive intelligence
• Work with Sales and Marketing to design and implement strategic direction for top prospects
• Partner with Sales Operations, Product, Technology, Marketing, and Client Services to identify, scope, and determine key prospects
• Drive new business and expand existing accounts to increase annual recurring revenue
• Sell Risk Adjustment and Quality solutions, including retrospective and prospective Risk Adjustment offerings, STAR ratings, HEDIS, and quality improvement solutions
• Execute the sales process by analyzing client workflows, matching needs to solutions, conducting presentations and demonstrations, negotiating pricing and contracts, closing sales, and updating the CRM
• Help identify, qualify, and pursue new business opportunities and maintain a healthy sales pipeline
• Engage management and executive-level prospects, build relationships, network with associations, and provide solution demonstrations
• Assist with RFI/RFP responses and coordinate with internal product experts
• Collaborate cross-functionally to support onboarding and long-term client satisfaction
• Monitor industry trends, customer challenges, CMS regulatory developments, ODAG/HPMS reporting requirements, and risk adjustment coding trends
• Provide pipeline forecasts, status updates, activity reports, and risk insights to sales leadership and teams

VP, Sales – Risk & Quality

Claims Specialist

• Process assigned claims based on client-specified guidelines or team-leader direction
• Meet productivity targets and financial and procedural accuracy standards
• Review claims-processing-system data to determine whether services were appropriate and benefit coverage criteria were met
• Review adjudication system edits to determine whether to pay claims and/or line items
• Mentor junior team members
• Collaborate on special projects, including process documentation, training, quality audits, and surge activity
• Communicate with management about issues and concerns and take preventive measures to ensure processing accuracy and quality
• Participate in projects involving provider data, authorizations, enrollment, or other activities
• Report to the Claims Team Leader

Medicaid Claims Examiner II

Enrollment Specialist

• Prepare, process, and maintain enrollment and disenrollment requests
• Verify and maintain applicable eligibility requirements
• Review and process CMS transactions
• Review Medicaid eligibility and complete verification processes
• Resolve enrollment system rejections according to regulatory and client-specific guidelines
• Reconcile membership reports as required by CMS
• Attend and successfully complete client and employer training
• Mentor junior team members
• Collaborate on special projects, including process documentation, training, and quality reviews
• Communicate with management about issues and concerns and take preventive measures to ensure case accuracy and quality
• Participate in management-assigned projects
• Perform other assigned duties

Commercial Enrollment Specialist II

• Prepare, process, and maintain enrollment and disenrollment requests
• Verify and maintain applicable eligibility requirements
• Review and process CMS transactions
• Review Medicaid eligibility and complete verification processes
• Resolve enrollment system rejections according to regulatory and client-specific guidelines
• Reconcile membership reports as required by CMS
• Attend and successfully complete client- and employer-scheduled training
• Mentor junior team members
• Collaborate on special projects, including process documentation, training, and client quality reviews
• Maintain communication with management regarding issues and concerns
• Take preventive measures to ensure case accuracy and quality
• Participate in management-assigned projects
• Perform other duties as assigned

Senior Medicaid Enrollment Specialist

Analyst

• Monitor and score call samples for Call Center agents
• Provide scorecard feedback and coach agents to increase quality awareness
• Partner with leadership and training teams to identify training opportunities
• Measure operational compliance with contractual KPIs, CPIs, and SLAs
• Track audit results from multiple sources and present trends and improvement suggestions
• Maintain accurate, traceable audit records and artifacts for internal and external agency/customer audits
• Log into the phone system monthly as an agent to receive and handle client calls
• Perform additional duties as needed to support team and business goals

Bilingual Quality Analyst

Recruitment

• Act as a player/coach by training and mentoring junior team members while maintaining a requisition load
• Serve as lead recruiter for positions across the organization
• Create and update recruiting processes, including job description maintenance
• Manage 1–3 team members, including recruiters and coordinators
• Work with leadership to understand business drivers behind hiring
• Partner with Finance on larger budget impacts and decisions
• Drive team performance through OKRs
• Partner with HR leadership to educate hiring managers and conduct interview training
• Advise and guide managers through the full recruitment lifecycle
• Provide an exceptional candidate experience
• Build the company brand through interactions with potential candidates

Manager, Talent Acquisition – Mexico

Director

• Execute a 24/7/365 global service desk strategy aligned with corporate IT objectives and business goals
• Foster customer service excellence, accountability, and continuous learning
• Build high-performing teams through recruiting, onboarding, and training
• Oversee daily operations of Tier 1, Tier 2/3, and hardware support service desk teams
• Establish SLOs, KPIs, and operational metrics to improve service delivery
• Drive AI transformation through intelligent ticket triage and routing, predictive issue detection, and self-service deflection
• Champion AI copilots and agentic tools for L1/L2 technicians
• Define and track AI-driven efficiency metrics
• Manage annual budget planning, forecasting, and cost optimization
• Implement and optimize follow-the-sun support across India, the US, The Philippines, Mexico, and the UK
• Manage third-party vendors, managed service providers, and technology partners
• Build partnerships with HR, Finance, and other corporate functions
• Implement and optimize ITSM tools, AI-enabled knowledge bases, and self-service portals
• Evaluate and implement AI-powered chatbots, automation, analytics, and emerging technologies
• Ensure integration between service desk platforms and email, IAM, and HRIS systems
• Drive adoption of remote support tools, asset management systems, and monitoring solutions
• Maintain security and compliance standards across service desk technologies

Director – Desktop Support

Full-stack Engineer

• Design and develop scalable, performant, and maintainable software features according to business requirements and technical specifications
• Build and maintain RESTful APIs using WebAPI and JSON for distributed systems
• Develop and optimize SQL database solutions, including scripts, stored procedures, functions, triggers, and performance tuning
• Create responsive user interfaces using AngularJS, Angular, and React
• Write clean, documented code following SOLID principles and design patterns
• Create comprehensive automated unit tests
• Identify and resolve concurrency issues, including blocking and deadlocking
• Debug complex issues and refine features based on testing feedback and production insights
• Contribute to technical design documentation and architecture decisions
• Participate in the full software development lifecycle from requirements analysis through deployment and production support
• Collaborate with Product Owners, Content Subject Matter Experts, QA Engineers, developers, and distributed teams across time zones
• Identify opportunities to leverage new technologies and streamline development processes

Senior Software Engineer

Program Manager

• Deliver Professional Services successfully to a portfolio of HealthEdge customers
• Work with Account Management, Sales, and customers to understand needs and assemble cross-functional teams
• Develop long-term account strategies and project pipelines with Account Executives
• Evaluate prospective customer needs and develop pre-sales implementation proposals
• Estimate and propose solutions using expert Professional Services resources
• Maintain project pipelines and re-forecast resource demands and revenue to optimize staffing
• Support creation and negotiation of Statements of Work
• Lead and support cross-functional teams including Project Managers, Consulting Leads, and Technical Product Leads
• Monitor project health, including schedule, margin, utilization, and customer and business objectives
• Identify and mitigate project and organizational risks
• Collaborate with HealthEdge and customer senior leadership to align expectations and processes
• Drive adherence to and refinement of best practices
• Monitor customer satisfaction and champion improvements to HealthEdge offerings
• Track client- and portfolio-level P&L with Professional Services PMO and Finance
• Manage customers to an appropriate level of profitability
• Act as an escalation point for complex or critical customer situations
• Prioritize HealthEdge deliverables across customers with peers and Account Management
• Perform functions consistent with HealthEdge policies and procedures, including PHI and PII handling requirements

Program Management Director

Call Center Representative

• Receive and respond to inbound phone calls for customer assistance
• Respond to outbound phone call requests
• Document all calls in ticketing and tracking systems
• Respond to customer inquiries and provide data within required time frames
• Act as liaison between the claims department and providers
• Research customer claims in primary payor systems
• Ensure the highest level of customer service on every call
• Perform other duties as assigned or necessary

Call Center Agent II

• Receive and respond to inbound customer assistance calls
• Respond to outbound phone call requests
• Document calls in ticketing and tracking systems
• Respond to customer inquiries and provide data within required time frames
• Act as liaison between the claims department and providers
• Research customer claims in primary payor systems
• Ensure the highest level of customer service on every call
• Perform other duties as assigned or necessary

• Receive and respond to inbound phone calls for customer assistance
• Respond to outbound phone call requests
• Document all calls in ticketing and tracking systems
• Respond to customer inquiries and provide data within required time frames
• Act as liaison between the claims department and providers
• Research customer claims in primary payor systems
• Ensure the highest level of customer service on every call
• Perform other duties as assigned or necessary
• Provide customer service to UST customers via inbound call center operations
• Report to the Customer Service Manager