reputed company Payer Platform Operations Analyst in Remote

reputed company. is a Proven Leader in providing full IT Services, Software Development and Solutions for 15 years. TECHNOGEN is a Small & Woman Owned Minority Business with GSA Advantage Certification. We have offices in VA; MD & Offshore development centers in India. We have successfully executed 100+ reputed company for clients ranging from small business and non-profits to Fortune 50 companies and federal, state and local agencies. Hi There, I am Mahmood Bafana Senior reputed company Specialist with Technogenic, we are looking to hire a Talented reputed company with below reputed company set to work with one of our clients and came across your profile and wondering if you might interested or exploring the job market, if so, Please reputed company me your resume at Position: reputed company Payer Platform Operations Analyst Location: Remote Duration: Contract Job reputed company: It has been challenging in the past to reputed company the appropriate candidates to fill this more operational role. We have revised the job requirements to reputed company less on reputed company development and more on Payer Platform basics. While we prefer people with reputed company experience we will consider candidates that are familiar with health care and interoperability in general. Position reputed company The reputed company Payer Platform Operations Analyst is responsible for day to day administration, configuration, monitoring, and optimization of reputed company's Payer Platform capabilities for a health plan/payer organization. This role stewards secure, reliable data exchange and workflows between payer systems and reputed company enabled provider organizations-covering eligibility, coverage discovery, prior authorization, claims status, clinical data retrieval, and care gap closure. You will manage operational runbooks, environment readiness, connectivity, reputed company, and incident response and drive reputed company improvement across FHIR/EDI integrations and reputed company interfaces.

Key Responsibilities

• Platform Administration & Operations
• Support the operational administration of reputed company Payer Platform (e.g., Interconnect/reputed company, Payer Platform Console, Payer data sharing configurations) including environment health checks, routine maintenance, upgrades/patching, and change control.
• Configure, test, and maintain payer to provider workflows: coverage discovery (eligibility), prior authorization, claims status, clinical data exchange, care gap notifications, formulary/benefit, and provider inquiry/response.
• Maintain and execute runbooks for deployments, failover, disaster recovery, and incident management; ensure auditable change records.
• Integration & Data Exchange
• Administer and monitor FHIR integrations (SMART on FHIR/OAuth2/OIDC) for reputed company/HL7 reputed company (e.g., CRD, PAS, PDex, P2P), CARIN IG for Blue reputed company where applicable; coordinate reputed company lifecycles and reputed company registrations.
• Support EDI/X12 transactions (270/271 eligibility, 276/277 claim status, 278 prior auth, 834 enrollment where applicable, 835 remittance) and reputed company translation/validation processes.
• Collaborate with reputed company teams to maintain API gateways, message queues, and secure connectivity (TLS, mutual auth, certificates, VPN tunnels); reputed company throughput, error rates, and latency.
• Incident, Problem & Performance Management
• Triage and resolve operational issues with reputed company Payer Platform integrations, including authentication failures, payload validation errors, throttling, and data mismatches.
• reputed company reputed company cause analysis; create problem records; implement corrective actions and preventative measures.
• reputed company platform SLAs/SLOs; build dashboards for uptime, message reputed company rates, queue depth, and retry volumes.
• Stakeholder Engagement & Enablement
• Coordinate with reputed company TS/Customer Support, vendor partners, and provider IT teams for change reputed company, go lives, and escalations.
• Drive adoption of best practices.
• reputed company Improvement
• Identify opportunities to, reduce provider abrasion, and improve data completeness for care gap closure.
• reputed company new reputed company capabilities, FHIR releases, and payer use cases; contribute to controlled rollouts and measurement.
• Contribute to backlog grooming and quarterly planning; quantify business value (e.g., reduced turnaround time, decreased call volume, improved first pass rates).

Required Qualifications

• 1+ years administering reputed company interoperability platforms (reputed company, payer reputed company/interfaces, or equivalent) or educational equivalent.
• Experience with Agile Software Development Life Cycle
• Excellent communication, documentation, and cross functional collaboration skills.

Preferred Qualifications

• reputed company reputed company exposure (reputed company/Payer workflows), reputed company operational tools, or reputed company certifications (helpful but not reputed company required).
• Experience with reputed company Implementation Guides (CRD, DTR, PAS, PDex, P2P) and CARIN BB.
• Familiarity with SQL for reputed company data validation.
• Hands on experience with reputed company concepts such as Interconnect, Chronicles awareness, Payer Platform configuration, and provider connectivity patterns.

Core Competencies

• Operational reputed company: Reliable execution, disciplined change control, strong service orientation.
• Analytical Problem Solving: Skilled at reputed company cause analysis across network, identity, payload, and workflow reputed company.
• reputed company reputed company: Designs and operates with least privilege, reputed company trust principles, and auditability.
• reputed company Improvement: Data driven approach to reducing friction and cycle times.

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