Senior Implementation Consultant

🕒 May 6

🇺🇸 United States – Remote

💵 $100k - $145k / year

⏰ Full Time

🟠 Senior

🛠️ Implementation Specialist

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Implement and configure Edifecs applications for payer systems on AWS, Azure cloud or virtual machines. • Implement and manage integrations between Edifecs’ products and solutions and Customer’s on-premise systems. • Analyze business requirements and translate them into technical configurations, workflows, and mapping documents. • Develop and test real-time and batch integrations using: EDI (X12: 834, 837, 835, 270/271, 276/277, 278) FHIR (CMS Interoperability APIs) HL7 v2/v3 • Implement service-based integrations via RESTful APIs, SOAP Web Services, ESBs, and iPaaS platforms. • Create mapping specifications and perform data validation, reconciliation, and error resolution. • Support ETL processes and legacy data migration to new payer systems. • Perform data profiling, cleansing, transformation, and loading activities. • Assist QA teams with creating technical test cases and validating system configurations and interfaces during SIT/UAT. • Partner with business analysts, SMEs, solution architects and delivery leads to ensure alignment of technical deliverables. • Develop appropriate training and development plans to meet the client's particular maintenance level and to configure the software according to the project plan. • Provide post-implementation support during the transition from implementation to maintenance. • Provide software and client specific training and develop training documentation based on present standards and client needs. • Participate in design workshops, integration sessions, and go-live readiness planning. • Provide technical guidance to junior implementation staff and contribute to solution documentation.

🎯 Requirements

• Bachelor’s in computer science, Information Technology, Information Systems or other technology related degree or equivalent experience in implementing, and operating Java stack-based enterprise applications. • 5+ years of experience in technical healthcare system implementation, preferably with a payer or health plan. • 3+ years of experience with Electronic Data Interchange (EDI) mapping and EDI analysis. • Deep understanding of X12 standards, FHIR and other standards based interoperability / integration patterns in the Healthcare Industry. • Hands on experience in analyzing transactions and creating interfaces for transactions such as X12 837, 835, 834, proprietary formats and deep knowledge of coding standards such as LOINC, SNOMED, ICD 10. • Familiarity with data formats: JSON, XML, HL7v2 messages, X12, flat files (CSV, pipe-delimited, etc.). • Strong knowledge of Edifecs Applications. • Decent knowledge of healthcare EDI transactions (834, 837, 835, 270/271, 278). • Proficiency in data modeling (logical & physical) and relational databases (SQL Server, Oracle) • Experience implementing solutions on AWS, Azure using CI/CD pipelines (GitLab, Jenkins, Terraform, CloudFormation) • Experience working in Agile or SAFe environments. • Working knowledge of java programming language and good understanding of SOAP and REST based webservices • Prior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions. • Prior experience in troubleshooting problems in java based applications using opensource tools / JDK tools such as jstack, visualvm, jconsole, jmap and similar tools to identify memory issues, deadlocks, application performance. • Experience using integration engines or tools (e.g., Mirth Connect, InterSystems, AWS Glue, Talend) is a plus. • Expertise with healthcare data domains: member, claims, provider, enrollment, and clinical data.

🏖️ Benefits

• medical, dental, vision, disability, and life insurance coverage • 401(k) savings plans • paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year