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Salary
$146k – $179k per year
Location
Remote (United States)
Seniority
Senior
Overview
Company
Impact
Profile match
HealthEdge builds core administrative software for health insurance payers. Its products handle claims processing, benefits configuration, care management and member engagement. Plans use the platform to replace decades-old claims systems.

Overview

Role Summary

HealthEdge's customer success strategy depends on four organizational capabilities: achieving customer outcomes, retaining and converting referenceable customers, expanding revenue within the existing customer base, and maintaining data and reporting integrity. The Senior CSE is the primary delivery vehicle for all four.

This is not a relationship management role. It is an outcome ownership role. A Senior CSE at HealthEdge is accountable for the promise between what a customer bought and what they are getting - and for resolving customer issues before they become an escalation, a churn risk, or a missed expansion opportunity.

The Standard: Every customer has a defined outcome, a health score grounded in evidence, and a Senior CSE who is accountable for mobilizing the cross-functional teams to achieve that outcome end-to-end

Responsibilities are organized by the four strategic outcomes the CSE organization exists to deliver. These are outcome areas with clear accountability - not task lists.

Customer Outcomes

  • Create and own a Customer Success Plan for every assigned customer account - tied to the customer's business objectives, not HealthEdge's delivery milestones.
  • Quarterback execution across Delivery, Operations, Technology, and Product. Own the outcome even when others own the task.
  • Translate HealthEdge platform capability into language, evidence, and outcome metrics that matter to customer executives.

Customer Retention & Referenceability

  • Surface account risk before the customer does. Identify the signal, act on it, and resolve the issue before it is raised.
  • Own the Path to Green plan for every at-risk account with named owners, dated milestones, and measurable outcomes. Own the plan - not the status update.
  • Convert satisfied customers into active advocates. Build and execute reference-development plans with excellence.

Customer Revenue Expansion

  • Identify multi-product and cross-sell opportunities tied to each customer's strategic direction and target business outcomes.
  • Partner with Sales to ensure expansion opportunities are handed off cleanly - nothing falls in the seam.
  • Maintain a current view of each customer's strategic roadmap and commercial architecture: contract terms, SLAs, pricing mechanics, and renewal dates. Bring commercial framing to every escalation.

Data & Reporting Discipline

  • Keep health scoring, CRM records, and success plans accurate, complete, and current - audit-ready at all times.
  • Contribute to consolidated reporting that gives leadership a trusted single source of truth.
  • Flag data gaps or health score discrepancies proactively - don't let a reporting issue become a surprise.

Strong candidates will demonstrate these behaviors consistently:

  • Proactive, Not Reactive
  • Owns the Accountability
  • Influences Without Authority
  • Communicates Directly and With a Plan
  • Composure and Confidence Under Pressure

Required

Experience

10+ years in health plan operations, healthcare consulting, or healthcare technology/services - serving or operating within enterprises of $1B+ revenue or equivalent-scale health plans. Demonstrated ownership of customer outcomes through difficulty (turnaround, escalation, or at-risk retention), with accountability to measurable customer-health, retention, or renewal targets. Proven delivery through teams the candidate did not manage.

Domain Knowledge

In-depth knowledge of health plan operations end to end: claims, enrollment, billing, provider/network data, utilization management, and the regulatory environment (CMS, state programs). Commercial fluency: contracting, vendor dynamics, SLA structures. BPaaS or managed-services delivery experience strongly preferred. Ability to run a distressed account back to health as a managed program - standing up the operating rhythm, sequencing the recovery, and de-escalating an executive relationship without over-promising. Demonstrated project or workstream management with named owners, dates, and dependencies through completion.

Technical Fluency

Deep experience with at least one enterprise-class core administration or payer platform (e.g., Facets, QNXT, HealthRules® Payer, or comparable systems). HealthEdge product experience a strong plus; where absent, HRP-suite working fluency expected within 6 months. Proven experience driving adoption of new technology in a commercial software environment. Fluent with modern work tools, including AI tools (e.g., Claude), as a daily working practice.

Preferred

  • Executive or senior-leadership role in a healthcare environment.
  • Experience on the health-plan side of a vendor relationship - having been the customer is a differentiator.
  • PE-backed, transformation, or turnaround environment experience.
  • HealthEdge product suite experience.
  • Hands-on exposure to a system implementation, platform migration, or major upgrade from any seat - testing, data conversion, cutover support, training, or PMO.

In the First 90 Days

  • Completes a full assessment of all assigned accounts - outcome case, health score, and risk register for each.
  • Identifies the two to three accounts with the highest churn or expansion risk and develops a preliminary Path to Green for each.
  • Builds working relationships with key internal counterparts - Delivery, Operations, Product, Technology, and Sales - before they are needed.
  • Demonstrates the behavior profile consistently: proactive, direct, composure under pressure, end-to-end accountability.

At 12 Months

  • Retention rate and health score improvement across the assigned portfolio.
  • At least one account converted from at-risk to referenceable.
  • One or more expansion opportunities identified and handed to Sales with clear commercial framing.
  • Portfolio data accurate, current, and audit-ready.
  • CSEs supported or managed are operating independently - not requiring gap-filling.
  • Calibration feedback from CSE leadership confirms the behavior profile is present and consistent.

Geographic Responsibility: Remote, US

Type of Employment: Full-time, permanent

FLSA Classification (USA Only): Exempt

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:

  • The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

  • Work across multiple time zones in a hybrid or remote work environment.

  • Long periods of time sitting and/or standing in front of a computer using video technology.

  • May require travel dependent on company needs.

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.

#LI-Remote

**The annual US base salary range for this position is $146,000 to $179,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.

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