Healthcare Advisor- Third-Party Administrator (TPA) Architect/ Consultant - Saviance Technologies
Dallas, TX
About the Job
Position: Healthcare Advisor- Third-Party Administrator (TPA) integration with Software solutions
Location: Remote
Employment Type: Part-time/Contract- 10-15 hours in a week
Job Summary: We are seeking a highly skilled and knowledgeable Healthcare Advisor with extensive experience integrating with third-party administrator (TPA) processes. You should have comprehensive functional, operational, and technical expertise in working with and deploying solutions integrated with Healthcare TPA platforms. The ideal candidate will work with the software solution architects to integrate the TPA workflows and processes into the software platform. The role will be to facilitate the integration of TPA processes and workflows into the claims processing. This role requires a strong understanding of TPA functions, operational workflows, and the technical aspects of software architecture.
Key Responsibilities:
Functional Expertise:
Understand the management and administration of healthcare employee benefits plans.
Understand the integration of claims processing, adjudication, and payment functions into TPA vendors.
Operational Expertise:
Monitor and improve operational workflows to ensure timely and accurate processing of benefits and claims.
Guide the customization of vendor platforms to work seamlessly with TPA enterprise software.
Technical Expertise:
Collaborate with TPA's and other software vendors to resolve technical issues and optimize system performance.
Ensure data integrity and security within benefits administration platforms.
Develop and maintain technical documentation and user guides for benefits administration systems.
Qualifications:
Bachelor's degree in Business Administration, Human Resources, Information Technology, or a related field.
Minimum of 10 years of experience in TPA functions, benefits administration, or a related field.
Strong experience on the TPA software vendor side.
Strong understanding of employee benefits plans, insurance policies, and regulatory requirements.
Proven experience in managing operational workflows and improving process efficiencies.
Technical proficiency in benefits administration software and systems (e.g., [specific systems]).
Excellent analytical, problem-solving, and decision-making skills.
Strong communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.
Preferred Skills:
Experience with healthcare benefits and claims processing.
Familiarity with HL7 standards and healthcare application development.
Knowledge of database management and SQL.
Experience with Microsoft technologies and Azure.
Location: Remote
Employment Type: Part-time/Contract- 10-15 hours in a week
Job Summary: We are seeking a highly skilled and knowledgeable Healthcare Advisor with extensive experience integrating with third-party administrator (TPA) processes. You should have comprehensive functional, operational, and technical expertise in working with and deploying solutions integrated with Healthcare TPA platforms. The ideal candidate will work with the software solution architects to integrate the TPA workflows and processes into the software platform. The role will be to facilitate the integration of TPA processes and workflows into the claims processing. This role requires a strong understanding of TPA functions, operational workflows, and the technical aspects of software architecture.
Key Responsibilities:
Functional Expertise:
Understand the management and administration of healthcare employee benefits plans.
Understand the integration of claims processing, adjudication, and payment functions into TPA vendors.
Operational Expertise:
Monitor and improve operational workflows to ensure timely and accurate processing of benefits and claims.
Guide the customization of vendor platforms to work seamlessly with TPA enterprise software.
Technical Expertise:
Collaborate with TPA's and other software vendors to resolve technical issues and optimize system performance.
Ensure data integrity and security within benefits administration platforms.
Develop and maintain technical documentation and user guides for benefits administration systems.
Qualifications:
Bachelor's degree in Business Administration, Human Resources, Information Technology, or a related field.
Minimum of 10 years of experience in TPA functions, benefits administration, or a related field.
Strong experience on the TPA software vendor side.
Strong understanding of employee benefits plans, insurance policies, and regulatory requirements.
Proven experience in managing operational workflows and improving process efficiencies.
Technical proficiency in benefits administration software and systems (e.g., [specific systems]).
Excellent analytical, problem-solving, and decision-making skills.
Strong communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.
Preferred Skills:
Experience with healthcare benefits and claims processing.
Familiarity with HL7 standards and healthcare application development.
Knowledge of database management and SQL.
Experience with Microsoft technologies and Azure.
Source : Saviance Technologies
