Healthcare payer jobs in Remote

Seattle, Washington

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2d ago

Test Lead Healthcare Payer Location: Seattle, WA Work Arrangement: Onsite 4 days per week Experience: 10+ years in Quality Engineering and Testing Key Responsibilities Lead end-to-end testing across multiple applications, interfaces, and healthcare business domains.Define test strategy, scope, coverage, estimates, schedules, and release readiness criteria.Manage SIT, E2E(end to end), regression, and UAT testing activities.Oversee test execution, defect triage, root cause analysis, risk mitigatio

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Contract, Third Party

Depends on Experience

Senior EDI Developer (Healthcare Payer - Facets Ecosystem)

Seattle, Washington

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Today

Role: Senior EDI Developer: Healthcare Payer (Facets Ecosystem) Location: Seattle, WA (Onsite from Day 1) Job Type: Contract Experience: 8+ years in IT, 5+ years in healthcare payer and EDI, 3+ years with Edifecs or TriZetto HIPAA Gateway Need candidates with Facets - Claims experience Role Overview: We are looking for a Senior EDI Developer with strong healthcare payer experience to design, develop, and optimize HIPAA X12 integrations within a Facets-based ecosystem. The role requires hands

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Third Party, Contract

Business Systems Analyst (ITS / Data Mapping / Healthcare Payer)

Remote

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Today

Job Title: Business Systems Analyst (ITS / Data Mapping / Healthcare Payer) Location: 100% Remote Ideal Candidate: A Healthcare Payer Business Systems Analyst with strong ITS/BlueCard expertise, hands-on data mapping experience, and the ability to bridge business and technical teams. Job Summary Xcelerate Health is seeking a Business Systems Analyst (BSA) with strong experience in ITS (Inter-Plan Teleprocessing System), BlueCard, and Data Mapping within the healthcare payer domain. The ideal can

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Contract

Depends on Experience

Senior EDI Support (Production Support) Specialist (Healthcare Payer - Facets Ecosystem)

Seattle, Washington

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Today

Role: Senior EDI Support (Production Support) Specialist (Healthcare Payer - Facets Ecosystem) Location: Seattle, WA (Onsite from Day 1) Job Type: Contract Experience: 8+ years in IT, 5+ years in healthcare payer and EDI, 3+ years with Edifecs or TriZetto HIPAA Gateway ROLE OVERVIEW: We are looking for a Senior EDI Support Specialist with strong healthcare payer experience to provide L2/L3 support for enterprise EDI platforms serving Claims, Membership, Enrollment, Provider, and Payment functi

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Contract, Third Party

Senior Business Systems Analyst (Healthcare Payer COB SME)

District of Columbia

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Today

18+ years of overall Business Analysis experience with 10+ years focused on Healthcare Payer operations and at least 7+ years in Coordination of Benefits (COB), Eligibility, Enrollment, and Member Data Management domains. Deep domain expertise in: Coordination of Benefits (COB) Primacy Determination Enrollment & Eligibility Medicare Secondary Payer (MSP) Medicaid Coordination Rules NAIC COB Guidelines Healthcare Payer Operations Member Matching / EMPI Provider and Payer Ecosystems Strong SQL an

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Contract, Third Party

Test Program Manager / QE Transformation Lead with Healthcare Payer (Facets) exp

Seattle, Washington

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Today

Role: Test Program Manager / QE Transformation Lead Location: Seattle, WA (4 days a week on-site is required) Job Type: Contract Required Experience: 12+ years of experience in Quality Engineering and Testing. 5+ years of experience leading large testing programs. Proven experience in discovery, due diligence, transition, and managed services engagements. Experience building or managing a Testing Center of Excellence (TCoE). Strong experience in workforce planning, hiring, and vendor management

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Third Party, Contract

Senior QA / Reconciliation Analyst with Healthcare payer / Medicaid / MMIS testing experience : Remote

Remote

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Today

Senior QA / Reconciliation Analyst Job Description Role Summary Senior QA and data-validation role focused on ETL testing, large-scale data reconciliation, regulatory-output validation, and root-cause analysis for AWS Databricks data pipelines. Roles & Responsibilities Define and execute test strategies for complex ETL / ELT pipelines and regulatory data outputs. Perform record-count, control-total, field-level, segment-level, and file-level reconciliation. Validate source-to-target mappings,

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Contract, Third Party

Depends on Experience

Senior EDI Support Specialist / EDI / Healthcare Payer | Facets Ecosystem

Remote

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Today

Request ID: 23873-1 Start/End Dates: 10/28/2026 - 12/31/2026 Tax Work Location: USA-Working from Home Job Title: Senior EDI Support Specialist / SalesMktg - Lead I - Product Support Job Description: Senior EDI Support Specialist (Healthcare Payer | Facets Ecosystem) Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway Summary: Seeking a Senior EDI Support Specialist with strong Healthcare Payer experience to provide L2/L3 support for enterprise

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Full-time, Part-time, Contract, Third Party

USD 55-60

FACETS Developer (Healthcare Payer)

Durham, North Carolina

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Today

Job Title: FACETS Developer (Healthcare Payer) Work Location: Durham, NC 27707 Job Details: Must Have Skills SQL Facets FACETS configuration, data analysis, troubleshooting, and database querying to support business and operational requirements. Nice to have skills FACETS Developer with hands-on experience in Claims Processing, Enrollment, and SQL Skilled in healthcare payer systems, FACETS configuration, data analysis, troubleshooting, and database querying to support business and operation

Contract, Third Party

Depends on Experience

FACETS Developer (Healthcare Payer)

Durham, North Carolina

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Today

FACETS Developer (Healthcare Payer) Durham, NC - Onsite Experience: 9+ years Inperson Interview is Mandatory Must Have Skills SQL Facets FACETS configuration, data analysis, troubleshooting, and database querying to support business and operational requirements. Nice to have skills FACETS Developer with hands-on experience in Claims Processing, Enrollment, and SQL Skilled in healthcare payer systems, FACETS configuration, data analysis, troubleshooting, and database querying to support bus

Third Party, Contract

Depends on Experience

Messagepoint Developer – Healthcare Payer

Remote

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Today

Messagepoint Developer Healthcare PayerW2 CANDIDATES ONLY Location: Remote Job Type: Contract Job SummaryWe are seeking an experienced Messagepoint Developer with hands-on experience in the Messagepoint platform and healthcare payer communications. The ideal candidate will be responsible for designing, configuring, and maintaining personalized member communications across print and digital channels. Key ResponsibilitiesDevelop, configure, and maintain Messagepoint templates, reusable content,

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Contract, Third Party

Depends on Experience

Functional Test Lead – Healthcare Payer / Facets

Seattle, Washington

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2d ago

Position SummaryWe are seeking an experienced Functional Test Lead with strong expertise in Healthcare Payer systems, particularly the Facets healthcare platform, to lead functional testing assessments, discovery workshops, and testing transformation initiatives. The ideal candidate will have extensive experience in Quality Engineering, healthcare payer business processes, testing program leadership, and managed services transitions. This role will assess existing testing capabilities, evaluate

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Full-time

Depends on Experience

Lead Google Cloud Platform Data Engineer – Healthcare Payer Experience

Remote

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Today

Were Hiring: Lead Google Cloud Platform Data Engineer Healthcare Payer Experience Location: 100% Remote (USA) Experience: 10+ Years Employment: W2 & Contract-to-Hire (CTH) Possible Top Required Skills: Google Cloud Platform: Google Cloud Platform and healthcare payer data integrations BigQuery, BigLake, Apache Iceberg & Starburst Dataproc, Data Composer, PySpark & dbt Data Integration: APIs, SFTP, Kafka, ETL/ELT pipelines Data Modeling, Data Quality & Performance Optimization Role Overview:

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Contract, Third Party

Depends on Experience

Business Systems Analyst (Healthcare Payer/Member Domain)

Remote

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21d ago

Role: Business Systems Analyst (Healthcare Payer/Member Domain) Experience:10+ years Location: Remote (USA) Must-Have Domain Skills Healthcare Payer / Member Domain Member Enrollment & Eligibility Benefits Administration Medicare, Medicaid, ACA Exchange Programs Member Operations Business Analysis Skills Requirement Gathering & Analysis BRD/FRD Documentation Functional Specifications & User Stories Process Mapping & Gap Analysis Data Analysis UAT Support Stakeholder Management Technical Skills S

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Contract, Third Party

Depends on Experience

Senior Data Analyst, Healthcare Payer Side - Predictive Analytics - Full Time, Direct Only

Remote

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15d ago

Remote opportunity for Permanent Residents Only The Senior Data Analyst will be an analytically driven team player, responsible for understanding business needs and objectives, eliciting requirements from stakeholders, and generating (SQL) and analyzing data and processes to identify opportunities for improvement, predictive ROIs and KPIs for Population Health Programs. In this role, you will be challenged to think creatively while developing actionable insights to inform client and program stra

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Full-time

110,000 - 130,000

Payer Healthcare Data Scientist, Manager

Boston, Massachusetts

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Today

Industry/Sector Health Services Specialism Operations Management Level Manager Job Description & Summary The Opportunity As a Payer Healthcare Data Scientist, Manager, you will play a pivotal role in transforming healthcare operations by leveraging data-driven insights to optimize payer processes. Within our Operations practice, you will be at the forefront of modernizing payer systems, working directly with clients to deliver impactful solutions that enhance efficiency and drive innovation

Full-time

USD 99,000.00 - 232,000.00 per year

HEDIS Analyst/Consultant

Remote

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20d ago

Hi Professionals, Title: HEDIS Analyst/Consultant Locattion: Remote JD: Must-Have: US Healthcare Payer Actuarial Underwriting HEDIS / Quality Claims & Enrollment Data PMPM / MLR / IBNR / Risk Adjustment SQL & Data Profiling Data Lineage / Data Mapping Business Rule Discovery Reverse Engineering Healthcare Analytics / Data Modernization Snowflake (Preferred) Key Requirements: Strong US Healthcare Payer domain expertise Experience with Actuarial, Underwriting & HEDIS/Quality Knowle

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Contract, Third Party

Depends on Experience

Senior EDI Developer / EDI developer

Remote

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Today

Job Description: Senior EDI Developer (Healthcare Payer | Facets Ecosystem) Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway Summary: Seeking a Senior EDI Developer with strong Healthcare Payer experience to design, develop, and optimize HIPAA X12 integrations within a Facets-based ecosystem. The role requires hands-on expertise in Edifecs/TriZetto HIPAA Gateway, EDI mapping, trading partner integrations, and high-volume transaction processing

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Full-time, Part-time, Contract, Third Party

USD 70-75

Business Systems Analyst (FACETS )

Seattle, Washington

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Today

Role: Business Systems Analyst (FACETS) Location: Seattle, WA Duration: 12 Months Job description: Client is seeking an experienced Business Systems Analyst (BSA) - Membership with deep expertise in the TriZetto FACETS Membership platform, including Enrollment and Billing operations within a Healthcare Payer environment. This role will serve as a Subject Matter Expert (SME) responsible for driving business analysis, solution design, system enhancements, regulatory mandates, and FACETS modern

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Contract, Third Party

Enterprise Architect

Remote

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Today

Enterprise Architect Position Overview We are seeking an experienced Enterprise Architect to help drive enterprise architecture initiatives, define future-state technology solutions, and support the delivery of strategic business capabilities across a complex enterprise environment. The ideal candidate will bridge business and technology teams, develop architecture roadmaps, and ensure solutions align with enterprise standards for security, scalability, interoperability, and operational excellen

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