HealthEdge

• Dashboard Design and Development: Build, publish, and maintain Tableau and Amazon QuickSight dashboards that serve internal HealthEdge operational and executive audiences. • Translate business questions into well-modeled QuickSight datasets and Tableau data sources, applying appropriate joins, calculated fields, parameters, and filters. • Apply strong visual design principles — clear hierarchy, intentional use of color, consistent layout, and accessible typography — so dashboards are immediately usable by their intended audience. • Optimize dashboard performance, evaluating SPICE vs. Direct Query in QuickSight and live vs. extract connections in Tableau, and managing refresh schedules. • Maintain a clean, well-organized portfolio of published assets across both BI platforms, retiring stale content rather than letting it accumulate. • Engage directly with internal business stakeholders across the organization to understand the decisions they need to make and what evidence would change those decisions. • Distill findings into clear narratives and recommendations; package insights so non-technical stakeholders can act on them without translation. • Collaborate with onshore and offshore data engineers to define and refine the analytics-ready data sources that power dashboards.

• Developing call centers' education materials, including written and digital presentations, how-to manuals, and instructional videos. • Preparing procedures and policies regarding call handling techniques and appropriate agent conduct. • Scheduling and conducting training sessions on various call center topics to prepare and support new employees. • Training experienced employees on new or updated call center procedures and scripts to improve their performance. • Observing the daily operations of call center employees and identifying any areas of improvement. • Monitoring recorded calls to identify training opportunities and upskilling requirements. • Liaising with team leaders and managers to conduct on-the-job coaching. • Measuring the effectiveness of training sessions and preparing individual or team progress reports.

• Leading business requirement conversations with customers and internal teams • Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems • Collaborate with business users, management, IT, and offshore staff • Produce the Requirements plan that aligns with the overall Project Implementation plan

• Manage all operations for a few processes/clients • Ensure team meets SLAs and KPIs • Identify process gaps and collaborate with clients to formulate solutions • Participate in building solutions for new opportunities • Guide and mentor junior associates • Lead projects with higher complexity levels

• Lead and manage end-to-end data conversion of healthcare payer data • Serve as subject matter expert for payer data domains • Analyze healthcare payer data patterns, perform data profiling • Design and execute a phased conversion plan • Write, maintain, and unit-test data conversion code • Design ETL processes including data extracts, load logic, and workflows • Handle post-installation testing and identify conversion defects • Maintain consistent communication with clients on progress and risks • Develop comprehensive documentation for data conversions • Collaborate with project managers and business teams • Mentor and guide junior team members

• Design, build and maintain pipelines that consolidate data from operational sources • Develop and curate data models that identify repeat incidents • Maintain data quality and governance standards across all ingested sources • Own and drive the Problem Management lifecycle across products • Build interactive dashboards and data visualizations • Present operational intelligence findings and outcomes to leadership

• Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows • Lead functional, integration, regression, and UAT cycles for assigned payer modules • Analyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution begins • Own defect lifecycle management: logging, triage, root cause classification, retest, and closure tracking • Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards • Support compliance and regulatory test cycles — ICD updates, CMS mandates, state-specific Medicaid rules • Coordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behavior • Produce daily/weekly execution status reports with defect metrics, coverage status, and risk flags • Manages offshore QA analysts.

• Design, configure, and maintain LAN/WAN, SD-WAN, VPN, firewall, and load-balancing infrastructure across multi-site and multi-cloud environments • Monitor network performance (SolarWinds, Datadog, ThousandEyes) and proactively resolve issues before they impact service delivery and SLA targets • Implement network security controls including firewall rule sets, IDS/IPS, segmentation, NAC, and zero-trust architecture principles • Design and manage AWS network infrastructure — VPCs, subnets, route tables, IGW, NAT Gateways, and ELBs — for scalable, highly available architectures • Configure AWS Transit Gateway and VPC peering for secure, low-latency connectivity across accounts, regions, and on-premises environments • Implement AWS Direct Connect and Site-to-Site VPN for hybrid connectivity between HealthEdge data centers and AWS • Administer AWS Route 53 including private hosted zones, resolver rules, and health-check-based routing policies • Manage AWS Security Groups, Network ACLs, AWS Network Firewall, and AWS Shield for least-privilege access and DDoS protection • Leverage AWS CloudWatch, VPC Flow Logs, and AWS Network Manager for observability, traffic analysis, and anomaly detection • Support Azure or GCP networking as required — VNets /VPCs, peering, and hybrid connectivity • Participate in 24/7 on-call rotation, triaging and resolving network incidents per SLA targets; contribute to post-incident reviews to drive MTTR reduction • Execute network changes through established change management processes; serve as Tier 3 escalation resource for complex issues • Develop automation scripts and IaC (Ansible, Terraform, CloudFormation, Python) to improve monitoring, alerting, and network deployment workflows • Maintain topology diagrams, runbooks, IPAM, and change records; support DR testing, vendor coordination, and legacy environment consolidation • Collaborate across Infrastructure, Security, DevOps, and Application teams; mentor junior team members

• Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team leader • Be responsible for meeting productivity targets, financial and procedural accuracy standards as established by management • Mentor junior members of the team • Collaborate with other team members on special projects as assigned by the team leads; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by the team leader • Knowledge base around physician practices and hospital coding, billing and medical terminology, CPT, HCPCS, and ICD-10, UB04, CMS 1500, authorizations, medical terminology, and concepts of healthcare • Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality

Role Description UST HealthProof is searching for a highly motivated Configuration Analyst to join our team. As a Configuration Analyst, you will be assigned to an implementation as a functional lead. You will: - Analyze business requirements, configure, unit test, and provide requirements to offshore for configuration in HealthRules Payor. - Ensure implementations are delivered successfully on time, and in alignment with project objectives by monitoring progress, identifying risks, and mitigation strategies as needed. - Work independently to solve and test complex scenarios. - Analyze data and draw conclusions. - Demonstrate excellent communication skills. - Understand and execute automation tools. - Assist other team members with complex issues related to their field of expertise. - Work in a team environment and share knowledge. Qualifications - Minimum high school diploma required; professional degree preferred. - Minimum 2 years’ HealthRules Configuration Experience. - Experience working in an offshore model is required. Requirements - Microsoft Word, PowerPoint, Excel, and Visio. - Experience with Agile tools and methodologies including JIRA and SCRUM. - Analytical abilities. - Critical thinking. - Leadership ability. - Familiar with debugging and testing concepts. - 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. Benefits - Remote work opportunity. - Full-time, permanent employment. - Exempt status under FLSA classification (USA Only). - Annual US base salary range of $100,000 to $120,000. Work Environment - The employee is occasionally required to move around the office. - Specific vision abilities required 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.