Consultant II

Role Description

Consultant II

Consultant II

Who We Are

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are

This role requires leading and managing teams, including a direct reporting team. You will work with teams to monitor and track ticket inventory and special projects. You will also mentor team leads, problem solve, solution and train as needed and will mentor direct reports to build the next generation of leaders. This role will also include working with either new customers directly or with the Delivery team to take over the configuration. You will ensure the SLAs are clearly defined and signed off as well as the JIRA workflow, establish desk level procedures and workflows as needed to define processes for team to follow. You must have excellent communication, critical thinking skills and must be an analytical person who’s able to grasp customer needs and works with the team lead to develop solutions as needed to support the customer.

The Opportunity

• Assist Director in bringing on new customers.
• Work with customers and develop process workflows
• Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
• Analyze business requirements, configure and unit test software (HealthRules Payor)
• Work independently to solve and test complex scenarios.
• Analyze data and draw conclusions
• Understand and execute automation tools.
• Synthesize complex information.
• Be flexible in work roles and hours.
• To work independently with little or no supervision
• Provide configuration training to internal team and customer.
• Work in a team environment and share knowledge
• Provide weekly status reports in power point presentations as well as release notes
• Must be able to plan and deliver on special projects as needed and drive the team to meet deadlines.
• Track tickets and formulate plan to remediate any issues as needed.
• Manage the ticket inventory and oversee the delivery.
• Ensure team is testing and documenting their results before moving to production environment
• Provide guidance and mentor team members.
• Provide expertise to customer and team regarding HealthRules
• Answer questions regarding the product and provide solutions to complex problems.
• Work with teams to quickly find and document root causes, and effectively communicate possible resolutions
• Communicate effectively across all levels within Technology, Business and Operations
• Approach problems as challenges and deal with them constructively while promoting this approach to the organization
  
  

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 Need

• Must have excellent communication skills and presentation skills including the ability to convey business requirements/configuration effectively
• Must have experience in at least four modules of HealthRules Payor (i.e., Benefits, Pricing, Claims, Finance, etc)
• Establish workflows as need as well as process improvement opportunities
• 4+ years HealthRules Configuration Experience
• Analytical Abilities
• Critical thinking
• Leadership Abilities
• Familiar with debugging and testing concepts
• Microsoft Word, PowerPoint, Excel and Visio
• Experience with Agile tools and methodologies including JIRA and SCRUM
• Experience working in an offshore model is required
• Possess a professional degree/diploma
• Must be a leader.
• Must be scrum master for configuration team.
  
  

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $115,000-$135,000

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

• Simplicity
  
  

Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

• Integrity
  
  

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

• People-Centricity
  
  

Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

• Leadership
  
  

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

#Healthproof

#CB

Skills

Healthcare,Configuration,Business Process