Principal, Health Plan Integrations (Medtech)

TL;DR

Principal, Health Plan Integrations (Healthcare): Leading the integration of health plan core systems with hirify.global's platform with an accent on defining integration requirements, ensuring data accuracy, and configuring complex system rules. Focus on navigating intricate health plan operations, managing data and operational workflows, and serving as a subject matter expert on integration best practices.

Location: Remote (US)

Salary: $150,000 - $190,000

Company

hirify.global is a healthcare company focused on streamlining medical imaging processes and reducing costs for patients, employers, and payers by providing a premium-quality radiology network.

What you will do

• Act as a subject matter expert on end-to-end health plan operations.
• Lead integrations between health plan core systems (claims, enrollment, care management) and hirify.global.
• Assist in defining integration requirements for file-based exchanges (834, 835, 837, custom flat files) and APIs.
• Ensure data accuracy, timeliness, reconciliation, and downstream usability for integrations.
• Partner with stakeholders to configure eligibility, benefits, claims rules, and medical management logic.
• Validate configurations through testing, UAT, and production readiness.

Requirements

• 8–10+ years of experience in health plan operations, healthcare IT, or healthcare implementations that involved health plan integration.
• Strong understanding of EDI (834, 835, 837, 270, 271), healthcare data flows, and reconciliation.
• Direct, hands-on experience with core health plan systems (e.g., Facets, QNXT, HealthEdge, Epic Tapestry, Amisys).
• Deep understanding of eligibility & enrollment processing, claims configuration and adjudication, claims billing, medical management systems, and vendor implementations.
• Comfortable translating business and clinical requirements into technical integration specifications.
• English: B2 required.

Culture & Benefits

• Opportunity to participate in equity incentive plans.
• Competitive benefits plans.