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HealthEdgeHE

Data Conversion Lead

HealthEdge empowers healthcare payers through innovative SaaS solutions, driving a digital transformation in healthcare.

HealthEdge

Employee count: 1001-5000

Salary: 130k-150k USD

United States only

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Overview

About HealthEdge HealthEdge® is trusted to provide the technology and services that power health plans’ most important value streams. With an integrated platform of solutions spanning claims administration, quality improvement, prospective payment accuracy, provider network management, care management, member engagement and risk adjustment, HealthEdge enables health plans to converge their data so they can harness automation and the promise of AI. Combining this next-gen technology with services and expertise gives health plans unmatched capabilities to deliver a future of frictionless and cost-effective healthcare experiences. For more information, visit www.HealthEdge.com.

Position Overview:

We are searching for a highly skilled and experienced Data Conversion Lead to join our growing team. The Data Conversion Lead will help in identifying the data requirement needs to continue to run the Core Business as usual while implementing the UST HealthProof’s core-admin ecosystem for our Health plan customers. The conversion lead will work with the Health Plan Customers, internal teams and SMEs to define the scope of business data conversion need and identify the conversion rules for the gaps between the Legacy and New CAPS platform and support technical system implementations. You should be an excellent problem solver who’s able to grasp customer needs and brainstorm ways to fulfill them.

Your Impact:

  • Lead/Manage data conversion of Healthcare payer data between 2 healthcare platforms
  • Subject matter expert in Healthcare payer domain especially Medical Claims adjudication systems
  • Deep knowledge of Healthcare payer entities like Claims; Enrollment and Provider and their data structures and relationships
  • Ability to analyze Healthcare payer data and define transformation and mapping rules required to migrate data from one platform to another
  • Ability to analyze data patterns; perform data profiling and data validations
  • Design and execute a conversion plan that sets realistic expectations.
  • Establish and maintain consistent communication with the client regarding progress of conversion
  • Lead Workflow / Gap process and analysis as we go through the process.
  • Handle and lead Mock and Parallel conversion activity.
  • Lead static data set up and testing process.
  • Demonstrate ability to flow and interact with company’s senior management Analytical and problem-solving skills
  • Participate in and/or Lead data conversion design and accuracy review.
  • Develop data conversion routines for multiple projects supporting several divisional/project initiatives
  • Directs in writing and maintaining data conversion code from documented logic and instructions of limited to moderate complexity
  • Performs code and unit testing for moderate to complex-scope data conversion routines
  • Responsible for post-installation testing correction of any conversion problems.
  • Assists in the planning and conducting of client/user review of conversion results (reports and implementation of corrections
  • Responsible for supporting implementation of moderate scope to major data conversions
  • Develops comprehensive documentation for all data conversions
  • Assists in writing and maintaining data conversion code from documented logic and instructions of limited to moderate complexity

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Bring:

  • Bachelor’s degree or higher in a related field
  • 12+ years of relevant work experience in technology integrations
  • 7+ years of work experience in technical leadership roles
  • Experience in architecting software solutions and understanding of architecture governance Experience on Healthcare around Provider; Claims; Enrolment and Auth is a must. Analyzing data using SQL (MySQL experience a plus but not required)
  • Experience with Healthcare Payor data domains – Provider/provider entities, enrollment entities, claims, accumulator, and authorization data entities
  • Experience with ETL tool and/or dB Visualizer a plus Experience with a BI tool such as MicroStrategy also a plus Outstanding planning and time management skills
  • Strong ETL experience / expertise is highly preferred
  • Solid experience of the healthcare industry is preferred
  • Experience with Medicare and Medicaid is preferred
  • Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus
  • Communication skills with peers, customers, and partners including the ability to convey information effectively and efficiently
  • Experience working in an onshore/offshore model is a must
  • Comfortable in a fully remote environment that relies heavily on asynchronous written collaboration and communication

HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace. We aspire to be a place where all employees have the opportunity to belong, make an impact and deliver excellent software and services to our customers.

Geographic Responsibility: While HealthEdge is located in Boston, MA you may live anywhere in the USType of Employment: Full-time, permanent

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:

  • The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
  • Work across multiple time zones in a hybrid or remote work environment.
  • Long periods of time sitting and/or standing in front of a computer using video technology.
  • May require travel dependent on company needs.

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.

**The annual US base salary range for this position is $130,000 to $150,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.

About the job

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Job type

Full Time

Experience level

Senior
Manager

Salary

Salary: 130k-150k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About HealthEdge

Learn more about HealthEdge and their company culture.

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HealthEdge® was founded in 2005 to deliver a next-generation Core Administrative Processing System – one that would not only increase accuracy and efficiency but also enable health plans to innovate and bring new lines of business to market swiftly. Our flagship product, HealthRules® Payer, has quickly gained acceptance and has positioned HealthEdge as a leader in digital transformation for healthcare payers.

Today, HealthEdge’s suite of cloud-based solutions enables health plans to thrive amidst the complexities of the healthcare landscape. We empower payers through increased operational efficiency, enhanced member engagement, and streamlined claims processing. Our goal is to drive down administrative costs while improving quality and patient outcomes, thereby creating a healthcare model that is sustainable for the future. By adopting our solutions, organizations can successfully transition into digital payers, ensuring compliance and efficiency in a rapidly evolving market.

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