Health plan operations platform managing claims, enrollment, and provider systems
UST HealthProof provides back-office operations services to health plans, handling claims processing, enrollment, and provider authorization at scale. The stack reveals a mature healthcare IT integration layer (Java, Spring Boot, ServiceNow, EDI, HL7) now adopting FHIR and HL7 standards — a shift toward modern interoperability with EHR systems. Hiring is heavily skewed toward operations and healthcare roles (20 of 26 open roles), with leadership gaps in integration and claims management, suggesting execution pressure on complex system migrations and surge activity.
Notable leadership hires: Integration Lead, Claims Team Lead, Appeals and Grievances Director
UST HealthProof operates as a business process outsourcing (BPaaS) partner for health plans, managing administrative functions including claims processing, member enrollment, provider networks, and payment authorization. The company serves mid-market and large health plans across the United States and maintains technical operations in India. Core infrastructure integrates multiple legacy systems (claims, enrollment, provider, authorization, payment) via EDI and emerging healthcare standards. Current focus spans process standardization across customer implementations, a multi-year risk adjustment product roadmap, and early-stage AI/ML exploration for operational use cases.
Java, Spring Boot, ServiceNow, AWS, SQL, Workday, ADP, and healthcare-specific standards including EDI, HL7, and FHIR. The company is actively adopting FHIR and HL7 for EHR interoperability.
Boston, Massachusetts. The company also maintains operations in India and is actively hiring in both the United States and India.
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