HealthRules/Facets/QNTX/HealthEdge-Healthcare Payer Core Platforms

Mandatory Skills : Healthcare Payer Core Platforms, APIs, Integration Technologies and Protocols Desired Skills : EDI, .xml, HealthRules Connector, MuleSoft, SOAP, REST API. HealthRules/Facets/QNTX etc.

Analyze business requirements and translate them into technical specifications for integration solutions.

Design, develop, test, and implement integrations between our core platform and healthcare payer systems (e.g., claims editing, enrollment, provider management, Prospective Payment System, Correspondence, billing & Payment, etc.).

Troubleshoot and resolve technical issues related to integrations, including data discrepancies, performance bottlenecks, and connectivity problems.

Collaborate with internal teams (e.g., development, product management) and external stakeholders (e.g., healthcare payers, vendors) to ensure successful integration implementations and ongoing support.

Develop and maintain documentation for integrations, including technical specifications, configuration guides, and troubleshooting procedures.

Stay current with industry trends and best practices in healthcare payer integrations and related technologies.

Experience of agile methodology, processes and tools such as Jira

Strong understanding of healthcare payer core platforms and data structures (e.g., claims, enrollment, provider data).

Hands-on experience with integration technologies and protocols.

Strong communication and collaboration skills, with the ability to effectively interact with both technical and non-technical audiences.

Experience with specific healthcare payer platforms (e.g., Facets, QNXT, HealthEdge).

Experience with data analysis and reporting tools.

Strong understanding of healthcare industry regulations and compliance requirements

Experience: -

10+ Years

Rate: -

Hiring mode:

Location: -

Remote