Senior Health Plan Ops Strategy & BPaaS Architect

HealthEdge; United States; Remote; USD 135,000 - 155,000; Full time

Job summary

HealthEdge is seeking a senior BPaaS strategy and service design leader to shape operating models and modernization roadmaps for Core Administration. The role collaborates with health plan executives and transformation teams to translate complex operations into scalable BPaaS solutions, including advisory for sales pursuits.

Ideal candidates have 5+ years in health plan operations and deep Core Admin experience, with a track record in consult­ing or advisory roles related to BPaaS.

Qualifications

• 5+ years in health plan operations or core administration
• Proven ability to design BPaaS service blueprints and future-state operating models
• Strong executive communication and client-facing presence

Responsibilities

• Lead service model design and blueprinting for Core Administration BPaaS transformations.
• Assess current-state operations on legacy platforms and define transition to BPaaS on HealthEdge ecosystem.
• Define operating models across claims, enrollment, billing, and member operations to improve efficiency and outcomes.

Skills

Executive communication

Analytical

Client-facing

Whiteboarding

Sales-facing skills

Tools

HealthRules Payer

Facets

QNXT

QicLink

Javelina

Job description

HealthEdge is seeking a senior BPaaS strategy and service design leader to shape operating models and modernization roadmaps for Core Administration. The role collaborates with health plan executives and transformation teams to translate complex operations into scalable BPaaS solutions, including advisory for sales pursuits.

Ideal candidates have 5+ years in health plan operations and deep Core Admin experience, with a track record in consult­ing or advisory roles related to BPaaS.