Remote Healthcare Program Director, HealthRules & Payer Ops

UST; Indianapolis (IN); À distance; USD 158 000 - 237 000; Plein temps

Avantages offerts par ce poste

Paid vacation and holidays

401(k) with company match

Health, dental, and vision insurance

Life and disability insurance

HSA/FSAs for healthcare and dependent?

Résumé du poste

UST is seeking a seasoned Program Director to lead end-to-end delivery for the Administrative Platform services in the HealthRules Payer ecosystem. You will govern governance forums, manage a broad set of integrations, and ensure successful delivery across health plan operations, enrollment processing, and reporting services.

You will drive compliance, security reviews, and governance for SLA/KPI attainment while coordinating with multiple partners to enable strategic growth and operational

Qualifications

• 20+ years in HealthRules Payer ecosystem required.
• Experience with Healthcare Payer Administration Platforms.
• Experience with Claims adjudication and enrollment processing.
• Proficient with EDI transactions (834, 837, 835, 270/271).
• Strong data integration and operational reporting background.
• HIPAA, HITRUST, and healthcare regulatory compliance knowledge.
• Experience with large-scale managed services and platform operations.

Responsabilités

• Own the overall service delivery strategy for the Administrative Platform engagement.
• Lead executive governance forums and quarterly reviews with client leadership.
• Oversee contract deliverables and ensure commitments are met.
• Provide executive oversight for HealthRules Payor, enrollment, claims, and reporting services.
• Establish governance to ensure SLA/KPI compliance and operational excellence.
• Drive incident/change/release governance and action on security and DR readiness.
• Manage offshore delivery compliance and data access controls as required.
• Report monthly SLA performance and KPI dashboards to client executives.

Description du poste

UST is seeking a seasoned Program Director to lead end-to-end delivery for the Administrative Platform services in the HealthRules Payer ecosystem. You will govern governance forums, manage a broad set of integrations, and ensure successful delivery across health plan operations, enrollment processing, and reporting services.

You will drive compliance, security reviews, and governance for SLA/KPI attainment while coordinating with multiple partners to enable strategic growth and operational