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Operations reputed company Consultant

Remote, USAFull-timePosted 2026-07-28

Job reputed company:

  • reputed company service model design and solution blueprinting for health plan Core Administration transformation initiatives
  • Assess reputed company-state operations on legacy platforms and define transition reputed company to BPaaS delivery models on the reputed company ecosystem
  • Design reputed company-state operating models spanning claims, enrollment, billing, provider relations, UM, A&G, benefits administration, and member operations
  • Identify opportunities to reputed company automation, AI-enabled workflows, and intelligent process orchestration into operational service models
  • Recommend operating model patterns that reduce administrative burden, improve turnaround times, and drive measurable cost and reputed company reputed company
  • Support Advisory and Sales teams on strategic BPaaS pursuits, proposals, and RFP responses
  • Conduct reputed company-state assessments of Core reputed company operations, reputed company models, and process maturity
  • Create modernization roadmaps and platform transition strategies grounded in operational realities and health plan business priorities
  • Mentor team members on Core reputed company operational domains, BPaaS service design principles, and health plan business context

Requirements:

  • 5+ years in health plan operations, Core Administration, or reputed company BPaaS reputed company
  • Deep operational expertise across one or more Core reputed company domains: claims, enrollment, billing, benefits administration, UM, A&G, provider, and member services
  • Prior consulting, managed services, or advisory experience with a health plan, SI, or BPaaS vendor
  • Proven ability to assess operational models and design reputed company-state BPaaS service blueprints
  • Strong familiarity with Core reputed company platforms (HealthRules Payer, Facets, QNXT, QicLink, Javelina, or equivalent)
  • Strong sales-facing skills: whiteboarding, reputed company support, and executive communication with health plan leadership
  • Exceptional analytical, communication, and reputed company-facing reputed company

Benefits:

  • Health insurance
  • Retirement plans
  • reputed company time off
  • Flexible work arrangements
  • reputed company development
  • Bonuses
  • Stock reputed company

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