HealthEdge

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 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
• Work across multiple time zones in a hybrid or remote work environment

Call Center Agent II

• 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 the required timeframe
• 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
• Report to the Customer Service Manager

• 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 payer systems
• Ensure the highest level of customer service on every call
• Perform other duties as assigned or necessary
• Report to the Customer Service Manager
• Work within an inbound call center serving UST customers

• 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

• 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

• 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 assigned or necessary duties

• 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 through inbound call center operations
• Report to the Customer Service Manager

• 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 a required time frame
• Act as liaison between 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
• Work across multiple time zones in a hybrid or remote work environment

Business Operations

• Own Atlassian architecture and governance across a multi-instance Cloud environment
• Define standards for permissions, SCIM/Okta identity, Jira at scale, customization, and simplification
• Own HIPAA/BAA compliance posture across products, Marketplace apps, integrations, and AI connectors such as Rovo
• Define licensing strategy with procurement, including demand forecasts, tier and seat modeling, and renewal recommendations
• Partner with senior stakeholders to redesign workflows and operating models during consolidation
• Communicate platform strategy and renewal decisions to executive-level stakeholders
• Lead two delivery tracks for internal HealthEdge teams and external customers through their managers
• Oversee a shared platform architect function
• Build technical judgment in-house and reduce reliance on outside consultants
• Set team ownership and delivery standards, reshape work division, and coach people leaders
• Apply an AI-first lens to platform design and support
• Deliver incrementally through experiments, measured risks, and shorter delivery cycles
• Travel as needed for client engagements and team leadership activities

Senior Manager, Business Systems

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 based on regulatory and client-specified guidelines
• Reconcile membership reports as required by CMS
• Attend and successfully complete client- and employer-scheduled trainings
• 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
• Research and resolve enrollment and billing discrepancies
• Build case files sent to the CMS Contractor for approval and resolution

Medicare Enrollment Specialist II

Manager

• Lead and develop a team of WFM Analysts supporting Contact Center and Back Office operations
• Provide day-to-day coaching, performance management and professional development
• Serve as the primary escalation point for scheduling issues, intraday staffing exceptions and real-time monitoring gaps
• Oversee production and publication of schedules across Contact Center and Back Office functions
• Ensure schedules meet coverage requirements, service level goals and turnaround time commitments
• Maintain scheduling policies and standards, including shift bid processes, time-off management, exception handling and schedule changes
• Partner with the Director of Resource Planning to translate staffing requirements into executable schedules
• Oversee real-time monitoring and intraday management across Contact Center and Back Office queues
• Establish escalation protocols and intraday response playbooks
• Review performance trends and address adherence issues, volume spikes and staffing shortfalls
• Oversee Back Office work distribution and queue management based on skills, complexity and regulatory deadlines
• Monitor inventory aging and TAT compliance across Claims, Utilization Management and other back-office functions
• Establish reporting for scheduling effectiveness, adherence, real-time performance and inventory health
• Review and validate reports and dashboards for operational leaders
• Track WFM metrics including schedule adherence, occupancy, shrinkage, TAT compliance and inventory aging
• Conduct one-on-ones and team performance reviews
• Liaise with Contact Center and Back Office operational leaders
• Collaborate with Resource Planning on capacity plans and scheduling execution
• Improve scheduling processes, tools and workflows
• Support WFM platform enhancements, configuration, testing and rollout activities

Manager, Workforce Management

Analyst

• Lead end-to-end forecasting and capacity planning across operational functions
• Convert projected demand into staffing requirements and hiring recommendations
• Develop and maintain short-, mid-, and long-range forecasting models
• Partner with Operations, Finance, and HR on workforce plans, budgets, hiring strategies, productivity expectations, and organizational goals
• Produce staffing plans identifying resource gaps, surpluses, risks, and opportunities
• Conduct variance analyses and improve forecasting accuracy, planning assumptions, and workforce models
• Translate capacity plans into staffing and work allocation strategies
• Support new business implementations, operational expansions, process transformations, technology deployments, and outsourcing assessments
• Serve as subject matter expert for workforce planning methodologies, capacity models, forecasting tools, and workforce analytics
• Work across multiple time zones in a hybrid or remote work environment
• Spend long periods sitting and/or standing in front of a computer using video technology

Senior Workforce Planning Analyst

• Lead and develop a centralized Resource Planning function serving Contact Center and Back Office operations
• Define the vision, standards and operating model for forecasting and capacity planning
• Build and mentor a team of resource planning analysts
• Advise senior operational, Finance and HR leaders on workforce demand, staffing risk and planning assumptions
• Own the accuracy and integrity of volume, workload and staffing forecasts
• Maintain and refine forecasting models based on business drivers, productivity assumptions, regulatory requirements and operational realities
• Oversee short-range and long-range staffing requirement outputs
• Align Resource Planning outputs with WFM scheduling teams
• Partner with Finance on headcount plans and budget cycles
• Collaborate with HR and Talent Acquisition on hiring timelines
• Engage Contact Center and Back Office leaders on planning assumptions and capacity risks
• Establish capacity outlook reporting for senior leadership
• Improve forecast accuracy, reduce variance and strengthen planning maturity
• Lead post-mortem reviews of significant forecast variances
• Evaluate and implement workforce planning tools and technologies
• Ensure back-office capacity plans reflect regulatory turnaround requirements
• Maintain documentation of planning methodologies, assumptions and model logic
• Define and monitor Resource Planning performance indicators

Senior Manager, Resource Planning and Forecasting

Program Manager

• Deliver Professional Services successfully to a portfolio of HealthEdge customers
• Work with Account Executives to develop long-term account strategies and project pipelines
• Evaluate prospective customer needs and develop pre-sales implementation proposals with Sales
• Estimate and propose solutions using expert Professional Services resources
• Maintain the upcoming-project pipeline and re-forecast resource demands and revenue
• 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 HealthEdge objectives
• Identify and mitigate project- and organization-level risks
• Align expectations and processes with HealthEdge and customer senior leadership
• Drive adherence to and refinement of internal and external best practices
• Monitor customer satisfaction and improve HealthEdge’s Professional Services offerings
• Track client- and portfolio-level P&L with the 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 duties consistently with HealthEdge policies and procedures, including PHI and PII handling

Call Center Agent II

Call Center Agent II

Call Center Agent II

Call Center Agent II

Call Center Agent II

Call Center Agent II

Call Center Agent II

Call Center Agent II

Call Center Agent II

Senior Manager, Business Systems

Medicare Enrollment Specialist II

Manager, Workforce Management

Senior Workforce Planning Analyst

Senior Manager, Resource Planning and Forecasting

Director, Program Management