Senior Applications Analyst

Summary

Join WelbeHealth as a Senior Applications Analyst and oversee the implementation and maintenance of core and emerging technologies, including TPA, EMR, CRM, and home-based systems. You will design and evaluate new technologies, resolve problems, provide end-user assistance, and support strategy. This role directly improves claims processing, provider payments, and scalable health plan operations. Key responsibilities include implementing new TPA and claims processing systems, configuring and maintaining adjudication logic, ensuring application alignment with business requirements, overseeing product updates, leading application implementations for new markets, collaborating with the training team, and performing workflow assessments. The ideal candidate possesses a Bachelor's degree (Master's preferred), extensive experience in healthcare applications and claims processing, and strong analytical and technical skills. WelbeHealth offers a competitive compensation package and a supportive work environment.

Requirements

• Bachelor’s degree in relevant field; master’s degree preferred
• Minimum of five (5) years of experience with healthcare applications and technologies including: Minimum of five (5) years of experience managing claims processing system functionality (e.g., design, configuration, testing, optimization, and support) in a healthcare payer, TPA, or claim delegated risk environment
• Advanced Microsoft Excel and PowerPoint skills required; strong data analytics and visualization skills required; PowerBI a plus
• Minimum of three (3) years of experience in a healthcare delivery environment
• Minimum of three (3) years of experience in technology solutions value creation such as in a product management, consulting, or business analysis role in a data-driven, fast-paced, high-growth setting

Responsibilities

• Work independently to research, define, plan, and implement new TPA and claims processing system, supporting payer-side workflows including benefits, eligibility, prior authorization, and provider payments
• Configure and maintain adjudication logic, provider contract terms, and fee schedules within the TPA platform to ensure accurate claims processing, payment and encounter submissions
• Ensure TPA (Quick Cap) and integrated applications align with business requirements and systems goals, meet end-user needs, and identify and solve systems problems, as well as ensure data accuracy across claims, eligibility, and provider files to support efficient processing and reduce rework
• Oversee product updates for business applications, feature customization and improvement, maintenance, support, troubleshooting, and customer service
• Lead configuration, planning, and implementation of WelbeHealth’s business applications needs for new market entry (launch)
• Collaborate with the Training team to ensure new technologies and updates are included in training materials and curricula
• Perform workflow assessments, design workflows to match business requirements, and provide trainings and remote support on core technologies when needed, as well as assess existing business applications used in operations and identify opportunities for increasing value creation and developing process improvement plans accordingly

Preferred Qualifications

Two (2) years of CRM or Care Management application experience preferred

Benefits

• Health Coverage on Day 1
• Paid Parental Leave
• 401K Match
• 17 days of paid time off in year one
• 12 company holidays and 6 sick days
• Career path advancement and leadership opportunities