Majesco Billing Expert - Policy Expert - Claims Expert

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As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Aetna's Voluntary (supplemental) business requires an accomplished Technical Lead/Expert with extensive knowledge & experience of Majesco LA&H platform. This critical role involves addressing significant challenges related to enrollment, billing, and claims processing on the Majesco LA&H Core Suite. The ideal candidate will be a hands-on expert in resolving defects, optimizing system performance, and guiding both Aetna and Majesco technical teams towards a stable and efficient production environment. 

Key responsibilities

• Lead Technical Stabilization & Defect Resolution: Take ownership of stabilizing the Majesco environment, particularly focusing on resolving high-priority defects and systemic issues impacting enrollment, billing, and claims processing
• Deep-Dive Analysis & Root Cause Identification: Conduct thorough analysis of existing issues, working closely with Aetna business and technical teams, and Majesco technical team to identify the root causes of recurring defects and performance bottlenecks
• Collaborate and Coordinate Resolution Efforts: Facilitate communication and collaboration between Aetna's technical teams (development, QA, operations), Majesco's technical support, and development teams to prioritize, escalate, and resolve open defects efficiently
• Drive Technical Design and Development: Guide the development and implementation of defect fixes, system enhancements, and necessary customizations within the Majesco platform, ensuring adherence to Aetna's technical standards and best practices
• Optimize System Performance: Identify and implement solutions to optimize the performance and scalability of the Majesco platform across Policy Administration, Enrollment, Billing, and Claims modules
• Enhance Integration Reliability: Ensure the stability and reliability of integrations between the Majesco platform and Aetna's front and backend systems, troubleshooting integration issues and optimizing data flow
• Mentor and Knowledge Transfer: Provide expert guidance and mentorship to Aetna's internal teams, fostering knowledge transfer and improving their ability to manage and support the Majesco platform
• Reporting and Communication: Provide regular updates to Aetna leadership on stabilization progress, key defect resolution efforts, and overall platform health

Required Qualifications

• Majesco Platform Expertise: Deep, hands-on experience with the Majesco LA&H Core Suite, including Policy Administration, Enrollment, Billing, and Claims modules. Experience with Majesco customizations, configuration, and API management is essential
• System Stabilization and Optimization: Proven track record of successfully stabilizing complex, enterprise-level insurance platforms, including resolving high-volume defects and optimizing performance
• Defect Management & Resolution: Extensive experience in defect triage, root cause analysis, and leading resolution efforts for critical business functionalities like enrollment, billing, and claims
• Insurance Domain Expertise: In-depth understanding of the Supplemental/Voluntary insurance business, including product lifecycle management, enrollment processes, billing operations, claims adjudication, and industry regulations
• Technical Proficiency: Strong proficiency in relevant technologies, such as Java, SQL, database management (e.g., Oracle, SQL Server), and integration technologies
• Collaboration & Communication: Exceptional communication and interpersonal skills to effectively collaborate with Aetna teams, Majesco technical support, and other stakeholders to achieve resolution.
• Leadership and Mentorship: Demonstrated ability to lead technical teams, guide problem-solving efforts, and influence positive outcomes in challenging technical environments
• Problem-Solving & Analytical Thinking: Superior analytical and problem-solving skills to dia