Req ID#: 399097
Remote, Any Location, US
Job Description:

ABOUT US

Foundever™ is a global leader in the customer experience (CX) industry. With 170,000 associates across the globe, we’re the team behind the best experiences for +750 of the world’s leading and digital-first brands. Our innovative CX solutions, technology and expertise are designed to support operational needs for our clients and deliver a seamless experience to customers in the moments that matter.

JOB SUMMARY

The Director of Integrated Solutions leads the design of innovative BPO solutions in the Healthcare industry. This role is critical to supporting healthcare payers, providers, and revenue cycle organizations through patient engagement, member services, provider support, and digital transformation initiatives. As the Subject Matter expert for the Healthcare Industry, work at the intersection of technology, compliance, and customer experience to create solutions that improve outcomes and drive patient/member satisfaction while ensuring strict adherence to healthcare regulations

QUALIFICATIONS

• 4–6 years of experience in healthcare BPO, healthcare operations, solution architecture, or account management
• Experience working with PHI, consent management, and secure communication channels.
• Bachelor’s degree or equivalent professional experience.
• Certifications Preferred:
  o Certified Revenue Cycle Professional (CRCP) – HFMA
  o Certified HIPAA Professional (CHP) or equivalent

o Project Management Professional (PMP) (particularly for implementation-heavy roles)

• Deep knowledge of healthcare processes and terminology—especially around payers, providers, RCM, and member/patient experience.
• Understanding of healthcare regulatory frameworks including:

o HIPAA (Health Insurance Portability and Accountability Act)
o ACA (Affordable Care Act)
o HITRUST (Health Information Trust Alliance)
o CMS guidelines (Centers for Medicare and Medicaid Services)
o PPACA (Patient Protection and Affordable Care Act)
o OSHA (Occupational Safety and Health Administration)
o AKS: Anti-Kickback Statute
Stark Law (Physician Self-Referral Law)

o State-specific healthcare compliance laws

• Proficiency in CRM systems, healthcare platforms (e.g., Epic, Cerner, Availity), and analytics tools.
• Strong commercial acumen and solution-selling experience.
• Strategic Thinking: Ability to develop and implement long-term strategies that align with business goals and industry developments.
• Cross-Functional Collaboration: Ability to work effectively with various teams, including IT, operations, compliance, and sales, to ensure integrated solutions meet all aspects of the business.
• Customer-Centric Mindset: Focus on understanding and addressing client needs, enhancing customer experience, and ensuring the delivery of value through integrated solutions.
• Problem-Solving Skills: Proficiency in identifying issues, analyzing data, and designing innovative solutions to complex challenges.
• Communication Skills: Strong verbal and written communication abilities, capable of conveying technical concepts to non-technical stakeholders and vice versa. Excellent storytelling skills, especially with executive healthcare stakeholders

PRE EMPLOYMENT REQUIREMENTS

Offers of employment are conditional and require that you complete and pass a criminal background check that reviews all criminal activity in every area of residence for the last seven years.

PRIMARY JOB RESPONSIBILITIES

• Design End-to-End Healthcare Solutions: Build integrated BPO solutions that support member services, patient access, claims management, provider support, revenue cycle management (RCM), and patient engagement.
• Ensure Compliance and Data Protection: Architect solutions with a deep understanding of HIPAA, HITECH, and other federal and state-level healthcare compliance requirements. Ensure solutions support PHI handling and protect patient/member data integrity.
• Client Discovery & Engagement: Lead discovery sessions with payer, provider, and RCM clients to identify challenges and opportunities for operational improvement, digital enablement, and enhanced customer journeys.
• Collaborate Across Teams: Work closely with Sales, Operations, Legal, Product, IT Security, and Implementation teams to deliver holistic solutions that meet business and compliance needs.
• Create Compelling Proposals & Presentations: Develop RFP/RFI responses, proposals, solution documentation, and ROI models tailored to healthcare clients’ unique needs.
• Infuse Digital Innovation: Incorporate technologies such as omnichannel communication, AI/GenAI, RPA, analytics, chatbots, virtual assistants, and self-service platforms into healthcare solutions.
• Support Sales Lifecycle: Act as a strategic advisor to internal stakeholders and clients throughout the sales process—from discovery to handoff—ensuring clarity, feasibility, and value delivery.
• Contribute to Industry Thought Leadership: Stay informed on healthcare industry trends, evolving CMS regulations, value-based care initiatives, and patient/member engagement innovations.
• Client-Facing Representation: Participate in client presentations, site visits, and due diligence meetings. Lead conversations around operational performance, compliance, and digital modernization.
• Protect company assets, systems, proprietary and confidential information in accordance with Foundever Associate Agreement.
• Proactively report actual or suspected ethics and compliance violations, vulnerabilities, security incidents and breaches in confidentiality, integrity or availability of Information assets as per the Company’s policy.

o Project Management Professional (PMP) (particularly for implementation-heavy roles)

• Deep knowledge of healthcare processes and terminology—especially around payers, providers, RCM, and member/patient experience.
• Understanding of healthcare regulatory frameworks including