reputed company Operations reputed company Consultant
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.
- Define how BPaaS service reputed company connect across the health plan ecosystem.
- Identify opportunities to reputed company automation, AI-enabled workflows, and intelligent process orchestration into operational service models.
- reputed company business cases demonstrating cost reduction, operational efficiency, scalability, and compliance improvements.
- 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.
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).
Benefits:
- Health insurance
- 401(k) matching
- reputed company time off
- Remote work reputed company
- reputed company development
Apply tot his job Apply To this Job