Senior Consultant - Program (Healthcare Payer)

Role: Primary liaison between Health Plan business leaders, IT leadership, product/platform teams, and delivery teams, across the HealthEdge HealthRules Payer (HRP) and GuidingCare (GC) ecosystem. The role is not hands-on technical delivery. The value is in understanding the business, building trust, translating between business and IT, and surfacing decisions so delivery leaders can focus on execution.

Responsibilities: Build trusted relationships with executives, operational leaders, product owners, SMEs, and IT teams. Translate business priorities into actionable IT discussions, and technical issues into business impact. Manage expectations and surface concerns before they become escalations. Maintain a high-level view of initiatives, dependencies, risks, and priorities without heavy reporting overhead. Drive alignment on priorities, owners, decisions, and next steps across Product, BA, Engineering, QA, architecture, and vendors. Create leadership-ready presentations and facilitate executive/steering discussions. Required 10+ years in healthcare IT, payer technology, TPM, BRM, or product/program leadership. Significant health plan/payer experience, with strong knowledge of payer processes and enterprise technology. Working knowledge of HRP and/or GuidingCare (both preferred).Direct work with VP/SVP/EVP/CIO/CTO-level leaders. Excellent executive communication, facilitation, negotiation, and conflict-resolution skills. Experience coordinating large, cross-functional initiatives with vendors and platform partners.

Preferred: HealthEdge implementations, conversions, or major enhancements. GuidingCare or comparable care/utilization management platforms. Prior BRM/TPM role inside a health plan. Familiarity with claims, enrollment, provider, UM, care management, and member services.