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[Remote] HealthRules Consultant I

100% Remote Full-time Open now

Note: The job is a remote job and is open to candidates in USA. UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. The HealthRules Consultant I will support configuration activities, manage incidents, and validate offshore configuration activities while leading a team of business analysts to ensure effective solutions for customers.

Responsibilities

  • Work with customers and develop process workflows
  • Supporting the patch and updates to applications
  • Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls
  • Analyze business requirements, configure and unit test software (HealthRules Payor)
  • Work independently to solve and test complex scenarios
  • Analyze data and draw conclusions
  • Demonstrate excellent communication skills
  • Understand and execute automation tools
  • Synthesize complex information
  • Be flexible in work roles and hours
  • To work independently with little or no supervision
  • Must have experience in at least two modules of HealthRules Payor (i.e., Benefits, Pricing, Claims)
  • Must be ready to take on additional roles and responsibilities to drive towards becoming a Configuration Lead
  • Assist other team members with complex issues related to their field of expertise
  • Provide configuration training to internal team and customer
  • Work in a team environment and share knowledge

Skills

  • Minimum high school diploma required. Professional degree preferred
  • Minimum 2 years' HealthRules Configuration Experience
  • Experience working in an offshore model is required
  • Microsoft Word, PowerPoint, Excel and Visio
  • Experience with Agile tools and methodologies including JIRA and SCRUM
  • Analytical Abilities
  • Critical thinking
  • Leadership ability
  • Familiar with debugging and testing concepts
  • Work with teams to quickly find and document root causes, and effectively communicate possible resolutions
  • Communicate effectively across all levels within Technology, Business and Operations
  • Approach problems as challenges and deal with them constructively while promoting this approach to the organization
  • Must have experience in at least two modules of HealthRules Payor (i.e., Benefits, Pricing, Claims)
  • Excellent communication skills
  • Critical thinking skills
  • Analytical person who's able to grasp customer needs and works with the team lead to develop solutions as needed to support the customer
  • Be flexible in work roles and hours
  • To work independently with little or no supervision
  • Assist other team members with complex issues related to their field of expertise
  • Provide configuration training to internal team and customer
  • Work in a team environment and share knowledge

Benefits

  • Full-time, regular employees accrue up to 16 days of paid vacation per year
  • Receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year)
  • 10 paid holidays
  • Eligible for paid bereavement leave
  • Eligible to participate in the Company’s 401(k) Retirement Plan with employer matching
  • Eligible for medical, dental, and vision insurance
  • Basic life insurance
  • Accidental death and disability insurance
  • Short- and long-term disability benefits
  • Purchase additional voluntary short-term disability benefits
  • Participate in a Health Savings Account (HSA)
  • Participate in a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses
  • Potential for quarterly incentive-based bonuses and or commissions depending on role

Company Overview

  • UST HealthProof offers risk adjustment, quality programs, and healthcare payer technology services. It is a sub-organization of UST. It was founded in undefined, and is headquartered in Aliso Viejo, California, USA, with a workforce of 501-1000 employees. Its website is https://usthealthproof.com.

Company H1B Sponsorship

  • UST HealthProof has a track record of offering H1B sponsorships, with 40 in 2025, 43 in 2024, 31 in 2023, 3 in 2022. Please note that this does not guarantee sponsorship for this specific role.

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