Jobs at HealthEdge

Design, develop, test, and maintain enterprise-scale healthcare software using C#, .NET, RESTful APIs, SQL Server, and modern JavaScript frameworks. Build scalable features, optimize databases, address concurrency issues, debug complex systems, contribute to architecture decisions, and support the full software development lifecycle. Collaborate with distributed cross-functional teams while helping modernize infrastructure through AWS migration, microservices, and cloud technologies.

Conduct prospective, concurrent, and retrospective utilization reviews for inpatient, outpatient, ambulatory, and ancillary services. Assess medical necessity, length of stay, care levels, appeals, benefits, eligibility, and coordination of care. Collaborate with medical personnel on treatment alternatives, transfers, discharge planning, and care plans. Research regulatory requirements, resolve authorization issues, coordinate services, and educate providers on policies and benefits.

Leads business and functional requirements for healthcare payer core administration implementations covering claims, enrollment, provider, authorization, and payment systems. Partners with customers, vendors, product, architecture, development, QA, and offshore teams to translate healthcare processes into technical requirements, workflows, user stories, and EDI mappings. Supports Agile ceremonies, solution design, risk management, stakeholder walkthroughs, MVP demonstrations, and go-live decisions.

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Own and improve enterprise integrations across payroll, benefits, identity, finance, and other systems. Monitor integration health, troubleshoot production failures, configure business processes, automate manual work, validate data, and partner with stakeholders on requirements and solutions. Document system architecture and data flows, measure outcomes, apply AI tools such as Claude, and support the evolution of integration platforms and business systems.

Provides L2 production support for enterprise healthcare applications, including incident management, troubleshooting, root cause analysis, SQL-based data corrections, configuration management, and customer communication. Collaborates with development, infrastructure, DBA, and product teams to resolve complex issues, coordinate fixes, maintain SLAs, and improve support processes through automation, monitoring, and alerting.

Leads frontend and UI architecture across legacy .NET Framework applications and modern ReactJS web platforms. Establishes engineering standards, modernization strategies, accessibility practices, and long-term technical direction. Develops scalable, secure, performant healthcare interfaces, mentors engineers, leads initiatives through the full software development lifecycle, and collaborates with Product, UX, QA, and architecture teams. The role also includes technical prototyping, production support, root cause analysis, and ensuring reliability across cloud-based or on-premise applications using AWS, Docker, and Kubernetes.

Develop and extend automated testing frameworks for complex healthcare software applications. Create and execute UI, API, performance, white-box, and black-box tests; identify defects and testing gaps; improve quality processes; support DevOps and CI/CD initiatives; and collaborate with product managers and developers to deliver reliable releases.

Owns and manages the product backlog for a healthcare claims administration platform. Translates stakeholder and healthcare requirements into epics, user stories, acceptance criteria, workflows, and functional documentation. Coordinates Agile ceremonies, collaborates with engineering, UX, QA, and stakeholders, and supports feature delivery. Applies knowledge of claims, billing, reimbursement, payer operations, healthcare regulations, and AI-enabled product management tools.

Provides frontline technical and product support to customers by diagnosing issues, troubleshooting Java-based applications, managing tickets within SLA requirements, and escalating complex problems. The role involves SQL and log analysis, customer communication, knowledge-base documentation, reusable scripting, and cross-functional collaboration. It also supports continuous process improvement and requires flexible availability across time zones for remote US team collaboration.

Provides senior-level support for ETL pipelines and software applications processing healthcare data. Responsibilities include troubleshooting production issues, developing code fixes, optimizing SQL and NoSQL databases, deploying and monitoring jobs, documenting processes, collaborating with customers and cross-functional teams, and improving operational reliability. The role also participates in Agile ceremonies, supports CI/CD automation, and provides occasional weekend support.

Lead sales growth and client expansion for HealthEdge’s Risk Adjustment and Quality SaaS/BPaaS solutions. Develop market and sales strategies, manage executive relationships, oversee complex sales opportunities and RFI/RFP responses, support demonstrations and negotiations, maintain pipeline forecasts, and collaborate with Product, Marketing, Technology, Client Services, and Customer Success. Focus on Medicare Advantage, ACA, and Managed Medicaid markets, including CMS requirements, STAR ratings, HEDIS, and retrospective and prospective risk adjustment programs.

Develop and support Java and Spring Boot applications, investigate complex production support tickets, perform root-cause analysis, implement fixes, optimize scalability and performance, and maintain software quality. The role includes software lifecycle ownership, architecture, testing, deployment, code reviews, technical mentoring, knowledge-base contributions, and collaboration with cross-functional teams. Frontend, Kubernetes, containerization, AWS, HRP Claims, and production-support experience are relevant.

Processes Medicare enrollment and disenrollment transactions, verifies eligibility, resolves system rejections, reconciles CMS membership reports, and maintains accurate billing and member data. The role investigates discrepancies, prepares case files for CMS contractor resolution, analyzes enrollment data and operational metrics, supports quality reviews and documentation, and mentors junior team members. It requires knowledge of Medicare Advantage, CMS transaction files, enrollment guidelines, and related billing systems.

Leads end-to-end healthcare payer data conversions between platforms, including profiling, transformation mapping, ETL design, mock and parallel runs, bulk loading, validation, testing, defect resolution, documentation, and client reporting. Develops Python and SQL conversion routines, manages risks and timelines, collaborates with onshore and offshore teams, and mentors junior staff. Requires expertise in claims, enrollment, or provider data and extensive technology integration leadership.

Manage talent acquisition for Mexico, serving as a lead recruiter and people manager for 1–3 team members. Responsibilities include handling requisitions, mentoring recruiters, advising hiring managers, improving recruiting processes, maintaining job descriptions, conducting interview training, tracking TA metrics and OKRs, and supporting high-volume hiring while delivering an inclusive, high-quality candidate experience.

Leads global 24/7/365 IT service desk operations supporting 7,500 employees across five countries. Oversees distributed Tier 1–3 and hardware support teams, service metrics, budgets, vendors, ITSM platforms, endpoint tools, and enterprise integrations. Drives AI transformation through intelligent ticket routing, chatbots, self-service, predictive analytics, and AI copilots. Ensures security, compliance, continuous improvement, and exceptional end-user experiences while partnering with corporate functions and managing global support operations.

Build and lead CI/CD platforms, infrastructure automation, Kubernetes deployments, and containerized testing environments across on-premises and cloud platforms. Develop deployment templates, monitor system health, support critical incidents, document architectures, and improve operational processes. The role mentors engineers, coordinates with stakeholders, and serves as a hands-on technical DevOps expert.

Administer Jira Software, Jira Service Management, and Confluence, including project configuration, workflows, permissions, service desks, automation, reporting, user access, governance, and platform hygiene. Provide first-line user support, documentation, onboarding, and basic training while escalating complex issues. Assist with migrations, upgrades, testing, compliance activities, licensing, and broader Atlassian improvement initiatives in a global organization.

Lead and grow the Bangalore-based Data Platform team, owning enterprise data platform strategy, architecture, and delivery. Design scalable batch and real-time pipelines, lakehouse and warehouse systems, governance, security, quality, and DataOps practices. Manage roadmaps, backlogs, hiring, mentoring, and stakeholder collaboration while evaluating modern data technologies. The role partners with product, engineering, analytics, data science, and global leadership teams to deliver reliable data solutions supporting reporting, analytics, and AI/ML initiatives.