Offer summary

Qualifications:

Bachelor's Degree required., 10+ years of experience in health plan operations technology and system vendor oversight., 3+ years of hands-on experience in Health Rules Payer Configuration., 5+ years of experience in claims, configuration, eligibility, and health plan operating systems..

Key responsabilities:

Oversee health plan operations systems including provider load, plan configuration, and claims.

Monitor production environments and work with the tech team for issue resolution and productivity improvements.

Maximize health plan operations performance and identify technology applications for improved scalability.

Drive vendor performance metrics and form strong relationships with the technology team for operational excellence.

Job description

NTT Data is currently seeking a Healthrules Payer Configuration Director to join our team working 100% remote, United States (US).

(**This position is W2 only and does not qualify for sponsorship or C2C)

Responsibilities:

Oversee successful functioning of health plan operations systems end-to-end including provider load, plan configuration, claims, enrollment, eligibility, employer group and provider operations
Monitor production environments, prioritization schedules, issue resolution, and vendor interfaces to optimize quality, reduce downtime, and increase efficiency and work with Tech team for problem resolution and productivity improvements
Work closely with business stakeholders to resolve any issues with systems and applications functionality both internally and across vendors
Maximize health plan operations performance across systems to drive efficiencies, creating market leading quality and operational administrative cost structure
Identify technology, automation and artificial intelligence application for health plan back office functions for improved scalability and speed to market
Think creatively and scale growing health plan system operations
Identify OKR, KPI, quality and monitoring performance metrics resulting in superior health plan operations delivery in configurations, claims, employer group and provider support
Drive appropriate SLA and vendor performance metrics for high performance end to end system functionality
Identify next level improvements to scale efficiently and effectively through AI and automation strategy development of both internal and external capabilities (vendor, BPO, claims edits)
Form strong relationships with technology team to drive system and technology efforts for market leading operations

Required:

Bachelor's Degree
10+ years health plan operations technology maintenance and system vendor oversight/monitoring, and system deployment experience
3+ years of hands-on experience in Health Rules Payer Configuration
5+ years of experience in claims, configuration, eligibility and other health plan operating systems

Preferred:

Expertise in claims, configuration, eligibility and other health plan operating systems
Experience in health plans system vendor oversight and monitoring

About NTT DATA

NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com.

NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

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