Job Description

Salary Range: $110,000 - $125,000 USD per year

SUMMARY OF OPPORTUNITY 

MacroHealth has an exciting opportunity for an experienced Healthcare Implementation Consultant to join our team and help us bring a transformational solution to life for our healthcare customers. 

Using your significant healthcare Payer operations experience, you will act as a trusted advisor to MacroHealth clients and partners to accelerate their ability to implement new network/vendor relationships that add value to our clients and their constituents. Your detailed understanding of US Healthcare Payers, specifically enrollment, claims, pricing and clinical operations will make you a natural for this role. Among other duties, you will be responsible for defining and gathering healthcare operations related requirements to drive development of EDI, JSON and other types of application configuration. 

This position requires you to be a self-starter with the ability to take ownership, work with tight timelines, and handle various tasks simultaneously while continuing to develop a positive work culture. You will be part of a growing team of implementation experts driven to deliver consistently exceptional service to our clients. 

KEY RESPONSIBILITIES OF ROLE: 

• Works closely with healthcare payers and provider networks to understand their operational requirements, allowing the creation of data exchange specifications to support healthcare data transformations 
• Documents client requirements and collaborates with team members to develop solutions that meet client-specific business needs 
• Translates client's business requirements into application configuration, workflows, business processes, and facilitates technical specifications 
• Leads clients through design and deployment of technical solutions 
• Creates and maintains implementation related documentation, such as business and functional requirements, process flows and configuration worksheets 
• Collaborates with other implementation team members and teams across MacroHealth to identify and develop solutions that deliver exceptional client value 
• Assist with the continuous improvement of implementation and service delivery best practices, processes, and tools 
• Communicates clearly and explains technical concepts in layman’s terms so that a non-technical audience can clearly understand what is needed for flawless implementations 
• Advocates for and evangelizes "best practices" to ensure long term success and value for MacroHealth and our clients 
• Builds and manages relationships at multiple levels of client organizations, from frontline staff to C-suite stakeholders 
• Collaborates with external client teams to understand evolving requirements/needs and communicate potential approaches to address them 
• Acts as a “trusted advisor” by payers and networks

Qualifications

WHAT YOU’LL NEED: 

• 6 + years’ experience in health plan operations (can speak to how a health plan/payer operates), especially enrollment, utilization management, and claims pricing, processing and payment functions 
• 5 + years’ progressive client-facing implementation or operations experience 
• A working knowledge of general healthcare IT and data exchange (EDI) operations 
• BA/BS degree in information technology, business, healthcare administration or related discipline 
• Proven success in working with a team to collectively define, isolate, analyze, comprehend and solve complex issues 
• Empathy and a passion for problem solving 
• Outstanding planning, negotiating, and influencing skills 
• Ability to effectively prioritize and execute tasks while working both independently and in a team-oriented, collaborative environment 
• Strong interpersonal skills including excellent written and verbal communication skills; listening and critical thinking; presentation and facilitation skills 
• Ability to develop strong working relationships with stakeholder groups, both internally and externally at any functional level 
• Outstanding task management skills across a varied set of responsibilities 
• Ability to thrive in a fast-paced, start-up environment 
• Serve as a role model of flexibility during organizational and/or business changes 
• Be able to travel up to 25% of the time

THINGS THAT MAKE A DIFFERENCE: 

• MS in Healthcare Administration, Business or other related degree 
• EDI technical expertise especially with ANSI X12 834, 837 and 835 transactions 
• Technical or IT Project or Program Management experience 
• Experience with Confluence, Jira and Smartsheet 
• Background in implementation of software as a service (SaaS) products

Additional Information

MORE ABOUT US

MacroHealth is a highly collaborative work environment where each team member can rely on the skills, expertise, and support of one another across the company. We operate with an open-door policy and are wide open to new perspectives for improving our operations and fueling future growth with a diverse and engaged team.  

WE OFFER

• Remote-friendly work environment 
• Flexible PTO with no annual upper cap 
• Extended parental leave  
• Equity awards 
• Extended medical, dental and vision plan for employee and dependents 
• 401(k) contributions matching

HOW WE PROTECT TEAM MEMBER HEALTH AND SAFETY 

At MacroHealth we recognize the impacts of the global pandemic have taken shape differently for each of us based on our role, our location, our family situations, and job transitions. Health, safety and wellbeing are top of mind for us in supporting safe office environments as well as engaging team members working from home. As part of this approach, a vaccination policy has been implemented requiring all eligible employees to be fully vaccinated against COVID-19 in order to work in one of our offices or travel to client locations. 

DIVERSITY, EQUITY, AND INCLUSION 

We are committed to facilitating constructive team member engagement and promoting a respectful work environment. We design our company processes to surface necessary conversations, engage multiple voices, remove barriers, and recognize contributions made at every level. We actively promote practices to create lasting change and partner with organizations that align with our values.

This role requires legal authorization to work in US.

MacroHealth is an equal opportunity employer.