Senior Consultant (Payer/Provider)
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- United States
- Work type
- Remote
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Senior Consultant (Payer / Provider)
We are looking for a Senior Consultant with deep domain expertise in the Healthcare & Life Sciences (HLS) sector—specifically focused on Payer (health plans, insurers) and Provider (health systems, hospitals, clinic networks) operations—to support our continued growth. In this role, you will review, analyze, and evaluate complex healthcare systems, operational workflows, and clinical/administrative requirements to improve member and patient experiences.
You will independently formulate and implement enterprise technology solutions—primarily leveraging Salesforce Health Cloud and the broader Salesforce ecosystem—that align with our clients' care delivery, patient access, member engagement, and digital health strategies. The Senior Consultant is responsible for driving clinical and business discovery sessions, mapping healthcare workflows, designing compliance-minded process improvements, building health data models, and delivering detailed functional designs. You will lead key workstreams, manage discrete project engagements, and serve as a trusted advisor to healthcare leaders.
Role Responsibilities:
We are looking for a Senior Consultant with deep domain expertise in the Healthcare & Life Sciences (HLS) sector—specifically focused on Payer (health plans, insurers) and Provider (health systems, hospitals, clinic networks) operations—to support our continued growth. In this role, you will review, analyze, and evaluate complex healthcare systems, operational workflows, and clinical/administrative requirements to improve member and patient experiences.
You will independently formulate and implement enterprise technology solutions—primarily leveraging Salesforce Health Cloud and the broader Salesforce ecosystem—that align with our clients' care delivery, patient access, member engagement, and digital health strategies. The Senior Consultant is responsible for driving clinical and business discovery sessions, mapping healthcare workflows, designing compliance-minded process improvements, building health data models, and delivering detailed functional designs. You will lead key workstreams, manage discrete project engagements, and serve as a trusted advisor to healthcare leaders.
Role Responsibilities:
- HLS Solution Delivery: Design, configure, and implement custom solutions on Salesforce.com, with a primary focus on Salesforce Health Cloud across Payer and Provider environments (including care management, patient access, provider network management, referral management, and 360-degree patient/member views).
- Domain & Business Analysis: Lead discovery workshops to translate complex healthcare operations (e.g., prior authorization, patient intake/onboarding, utilization management, care coordination, provider onboarding) into clear requirements, process flows, and technical designs.
- Client & Team Leadership: Work collaboratively with cross-functional Coastal and client teams; exercise independent judgment on small-to-medium engagements or lead major workstreams on large enterprise transformations.
- System Design & Integration: Oversee Salesforce administration, configuration, data modeling, data migration, and integration strategies involving core healthcare platforms (e.g., Electronic Health Record [EHR/EMR] systems like Epic/Cerner, claims engines, practice management systems, and HL7/FHIR standards).
- Stakeholder Management: Facilitate cross-departmental alignment across clinical, administrative, operational, IT, and compliance stakeholders through structured communication and value-driven technical demonstrations.
Experience/Skills Required:
- 5–7 years of total professional experience, including at least 2+ years in consulting and direct experience delivering tech solutions within the Payer or Provider spaces.
- Payer / Provider Domain Expertise: Hands-on experience implementing Salesforce Health Cloud and a strong working knowledge of core healthcare workflows (care coordination, patient acquisition, member services, or network operations).
- Salesforce Certifications: Active Salesforce Administrator certification required; Salesforce Health Cloud Accredited Professional or additional Salesforce Consultant certifications (Sales, Service, Data Cloud) are highly preferred.
- Interoperability & Data Modeling: Solid understanding of healthcare data models, HIPAA compliance considerations, and common integration standards/protocols (FHIR, HL7, APIs) used to connect Salesforce with EHRs, payer claims systems, or patient portals.
- Enterprise Integration Awareness: Fundamental understanding of enterprise architecture, SaaS best practices, and multi-system data flows within complex health systems or health plans.
- Client Communication: Exceptional verbal and written communication skills with the ability to bridge the gap between technical teams, healthcare administrators, and clinical leaders.
- Leadership & Independence: Demonstrated ability to manage project deliverables, solve complex healthcare problems creatively, and lead workstreams with minimal direct supervision.
- Work Authorization: Must have full-time permanent US work authorization.
Additional Preferred Experience/Skills:
- Bachelor’s Degree preferred, or equivalent experience
- Business Process
- Process Flow Analysis
- Requirements Definition
- Configuration Workbook
- Data Models
- Detailed Functional Design
- Project Plan
- Seeks opportunities to develop professional skills
- Achieves one technical certification each quarter as specified by immediate supervisor/manager
- Travels with client or project team as needed
Why Coastal, and what we offer:
- Flexible working hours with an emphasis on a life-work balance (in that order!)
- Remote flexible work; “Live by the beach, work in the Cloud,” plus company office locations in Palm Coast, FL; Atlanta, GA; Tysons, VA & Lexington, KY; travel as required to client locations
- Unlimited Paid Time Off (RTO), 401K with Company Match, and Medical, Vision, & Dental coverage
- Competitive quarterly bonus opportunities
- Continuing education and certification reimbursements, specifically within the Salesforce and Snowflake ecosystems; plus occasional in-house competitions with spot bonuses
- A flexible and fun team culture! We value transparency, support, flexibility, growth, teamwork, fun, and so much more
- Frequent team and culture activities, virtual & in-person, including Lunch and Learns, Happy Hours, team-building events
- Monthly All-Hands calls to bring the company together, and an open-door leadership policy with access to mentorship and guidance
- Opportunities for accelerated growth, networking, and career guidance and support
- Trust, transparency and respect across all levels of the company
Coastal provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
