• Lead the collection, validation, and documentation of requirements across eligibility, enrollment, contribution accounting, member and employer services, vendor integrations, notifications, reporting, and compliance.
• Provide ongoing communication, status updates, and issue escalation to the client, project sponsor, and steering committee.Implementation Program Management• Oversee all implementation workstreams and ensure alignment across internal business and technical teams.
• Lead project resources including project manager, business analyst(s), data conversion analysts, and cross-functional leaders.
• Ensure adherence to implementation timelines, milestones, and deliverables.
• Maintain oversight of project governance, risk mitigation, and change control processes.Data Conversion Leadership• Serve as the business lead for the data conversion workstream.
• Oversee data mapping, transformation rules, validation cycles, reconciliation, and quality assurance.
• Coordinate data extraction, cleansing, normalization, and test cycles with client and internal teams.Technical & Operational Implementation• Translate client requirements into system specifications and configuration instructions.
• Collaborate with technology teams on development, enhancements, system integrations, and testing activities.
• Lead functional testing, UAT coordination, and defect resolution processes.
• Support readiness activities including training, communication planning, cutover, and go-live execution.Required Qualifications• 7+ years of experience in benefits administration, TPA operations, or a related technology or healthcare benefits environment.
• Demonstrated experience leading complex client implementations or enterprise system deployments.
• Strong experience with data conversion, data mapping, and validation processes.
• Experience managing cross-functional project teams.
• Strong analytical, organizational, and problem-solving capabilities.
• Excellent interpersonal, communication, and client-facing skills.Preferred Qualifications• Experience with union benefit funds, Taft-Hartley plans, or multi-employer funds.
• Exposure to benefits administration systems, enrollment platforms, or healthcare data environments.
• Technical/programming familiarity (e.g., SQL, Python, .NET, Java) with ability to interpret data structures.
• Experience with EDI transactions (834, 820), XML, JSON, or flat files.
• Knowledge of HIPAA, PHI/PII data security, and benefits regulatory requirements.
• Experience with vendor integrations involving carriers, PBMs, or vision/dental partners.
• Certifications such as PMP, PMI-ACP, CBAP, or CSM.
About
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.
Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.
Come be a part of the Brightest Ideas in Healthcare™.
Company Mission
Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.
Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected]
Top Skills
What We Do
Brighton Health Plan Solutions (BHPS) is a health care enablement company that is transforming the way health care is accessed and delivered. Our innovative, customizable, sustainable solutions encourage patient activation and improve the quality of care — all at lower cost. We effect impactful change for self-funded plan sponsors, health systems, and TPAs through our extensive health care expertise: •Decades of health plan design and health plan management experience •Proprietary MagnaCare, Create®, and Casualty provider networks •Strong provider relationships •Cutting-edge, white-labeled technology platform that enhances the experience for providers, plan purchasers and health care consumers
