Why This Role Stands Out
Leverage your deep healthcare provider domain and technical expertise in this hybrid role, where you'll translate complex business needs into scalable solutions and solve intricate data integration challenges. This is an excellent opportunity to grow your skills within a reputable company, collaborating with both business and technical teams to drive impactful innovation.
Quick Overview
Seniority
Mid Senior
Work mode
Hybrid
Location
United States
Posted
4 days ago
SOAPSQLETLOnboardingREST
Job Description
Senior Provider Data Management Technical / Domain SME
We are seeking a Senior Technical Professional with 12 15 years of experience who brings a strong combination of healthcare provider-domain expertise and hands-on technical/application integration experience. The ideal candidate must understand Provider Data Management (PDM), Provider Network and Contracts, credentialing, and healthcare payer operations, while also being capable of working deeply with APIs, integrations, data, rules engines, workflows, and application configurations.
This is a hybrid provider-domain and technical role. The candidate should be able to translate provider business and operational requirements into scalable technical solutions, troubleshoot complex provider data and integration issues, and work effectively with both business/domain stakeholders and technical teams.
Key Areas of Experience
- Provider Data Management (PDM) and Provider Network/Contracts
- Provider onboarding, credentialing, contracting, and network management
- Strong understanding of healthcare payer systems and provider lifecycle processes
- REST/SOAP APIs, ETL, and application/system integrations
- SQL and hands-on provider data analysis and troubleshooting
- Rules engines such as Drools/Kogito
- Provider data quality, Master Data Management (MDM), match/merge, and data governance
- Workflow/BPM configuration and business process automation
- CI/CD and application configuration promotion across environments
- Integration with Claims, Provider Directory, Provider Portal, and other payer applications
- Ability to analyze and resolve issues spanning provider data, business rules, workflows, applications, and integrations
- Ability to translate provider-domain/business requirements into technical specifications and solutions
- Experience collaborating with provider operations, business SMEs, architects, developers, integration teams, and other technical stakeholders
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