Senior Consultant - Configuration Management

We are seeking an experienced Senior Consultant – Configuration Management with strong expertise in HealthEdge Guiding Care. The ideal candidate will have hands-on experience across multiple Guiding Care modules, configuration, design documentation, SQL, APIs, and stakeholder collaboration.

Roles and Responsibilities

• Configure and support various HealthEdge Guiding Care modules, including:
  • Care Management
  • Utilization Management
  • Appeals & Grievances (G&A)
• Analyze business requirements and translate them into functional and technical design solutions.
• Develop detailed design documents based on business requirements.
• Perform configuration and unit testing within the Guiding Care application, particularly the G&A module.
• Work with Business Rules and SmartComm Letters configuration.
• Utilize SQL to validate data and support application configuration.
• Work with Guiding Care database structures for troubleshooting and solution development.
• Collaborate with QA teams to clarify defects, answer functional questions, and support testing activities.
• Communicate effectively with business stakeholders to gather requirements and provide solution recommendations.
• Support application integrations through APIs and internal interfaces.

Required Skills

• Strong experience with HealthEdge Guiding Care modules:
  • Care Management
  • Utilization Management
  • Appeals & Grievances
• Experience with Business Rules and SmartComm Letters.
• Ability to analyze and understand business requirements.
• Experience creating functional and technical design documents.
• Hands-on experience with Guiding Care database structure.
• Strong knowledge of SQL.
• Experience working with APIs and application integrations.
• Ability to perform unit testing, especially within the G&A module.
• Excellent communication and stakeholder management skills.

Preferred Skills

• Experience integrating Guiding Care with other internal applications.
• Knowledge of Azure DevOps (TFS) and ServiceNow.

Preferred Qualifications

• Experience working in healthcare payer environments.
• Strong analytical, problem-solving, and documentation skills.
• Ability to work independently while collaborating with cross-functional teams.