Key Responsibilities
- Support data integration, mapping, validation, testing, deployment readiness, and ongoing system operations.
- Coordinate source data availability across claims, encounters, clinical data, formulary data, drug benefits, and recipient records.
- Support monthly formulary updates and ensure one-business-day availability for required healthcare datasets.
- Validate recipient coverage, active member status, dates of service, and payer-to-payer lookback requirements.
- Assist with system connectivity across interoperability platforms, portals, and data warehouse environments.
- Develop and execute system, integration, regression, and API testing, including user acceptance testing support.
- Maintain detailed test evidence, defect logs, validation results, incident reports, and readiness documentation.
- Support and maintain test environments for pre-production validation of system enhancements.
- Provide ongoing operational support for platform modules, API users, developers, and internal staff.
- Assist with third-party onboarding, attestation support, sandbox testing, and privacy/security review coordination.
- Monitor system performance to support 99.9% availability goals and escalate incidents as needed.
- Prepare training materials and self-service documentation for system functionality, reporting, and support procedures.
- Provide customer support for member inquiries, staff troubleshooting, and third-party developer questions.
- Ensure strict adherence to government security and privacy standards, including handling of PII, PHI, and sensitive healthcare data.
- Leverage approved AI/ML and LLM tools for test generation, anomaly detection, documentation, and workflow automation.
Qualifications:
- Must be a U.S. Citizen.
- Associate degree or equivalent professional experience.
- Minimum of four (4) years of experience in data integration, QA, DevSecOps, technical support, or healthcare IT operations.
- Proficiency with SQL and ETL/ELT processes.
- Experience with API testing tools, test scripts, validation reporting, defect tracking, and monitoring tools.
- Familiarity with healthcare data standards including FHIR resources, claims, encounters, clinical and formulary data.
- Knowledge of OAuth 2.0, OpenID Connect, and SMART on FHIR workflows.
- Ability to support CI/CD processes, release readiness, and system monitoring activities.
- Strong attention to detail with a commitment to data integrity, accuracy, and security.
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
- Strong written and verbal communication skills to collaborate with technical teams, users, and external developers.
- Experience supporting secure environments with strict compliance requirements.