Healthcare IT Technical Operations Associate III at HealthEdge

Job description

HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com. The Healthcare IT Technical Operations Associate III (L2) owns failure handling, reprocessing, and data reconciliation across healthcare systems and workflows. The role picks up job failures, fallouts, and reprocessing requests detected and raised by L1, performs initial investigation and triage, and works alongside L3, product, and other stakeholders to drive resolution. Once a fix or instruction is available, L2 executes reprocessing and data correction hands-on. The L2 associate owns end-to-end data integrity through structured reconciliation and validation controls, and partners with L1, development, and client teams to ensure operational continuity. As a Healthcare IT Technical Operations Associate III (L2), you will be accountable for the following: • Investigate and triage job failures, fallouts, and reprocessing requests raised by L1 • Perform initial analysis using application logs, database queries, monitoring tools, and upstream/downstream dependency checks to support root cause identification • Work alongside L3, product, and other stakeholders to drive root cause identification and resolution, providing analysis, context, and coordination throughout • Execute data correction and reprocess failed or fallout records per standard procedures once a fix or instruction is available • Validate outcomes after reprocessing and confirm successful completion • Support implementation of preventive actions for recurring failures in coordination with L3 and product teams • Perform record count reconciliation between input and output files, tables, and messages, and detailed reconciliation beyond basic counts as defined in the runbook • Execute periodic reconciliations across all interfaces to ensure end-to-end data integrity • Timely completion of adhoc customer requests • Analyze and resolve record count mismatches, data mismatches, duplicates, missing transactions, and out-of-balance conditions • Define and enhance reconciliation control mechanisms and validation checkpoints • Maintain reconciliation logs and audit trails for all data correction and reprocessing activity • Analyze inbound and outbound interface issues across systems • Coordinate with external vendors, trading partners, and upstream/downstream teams for file failures, format issues, delays, and data discrepancies • Provide functional guidance to L1 for complex monitoring and triage scenarios • Review L1-raised tickets for completeness and drive faster resolution • Contribute to runbook and SOP updates so recurring patterns are easier for L1 to detect, report, and route • Publish periodic reports on reconciliation status, fallout and reprocessing volumes, and SLA performance • Document and communicate open reprocessing activities, pending reconciliations, and business-critical risks during shift handover • Identify recurring failures and support permanent fixes and process improvements • Recommend automation opportunities for reconciliation and monitoring activities • Contribute to best practices and process standardization across interfaces This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. What You Need: • Bachelor's degree in Computer Science, Information Technology, or a related field • Minimum 3-4 years of experience in application support, technical operations, or production support roles • Experience with healthcare platforms such as HealthEdge, Facets, or QNXT • Experience with healthcare data formats such as EDI X12 (270/271, 276/277, 834, 835, 837) • Ability to clearly communicate with external customers • Experience with production monitoring tools for investigation and support • Experience with ITSM tools such as Jira or ServiceNow • Hands-on experience with SQL for data validation, log analysis, and reconciliation queries • Solid understanding of incident management, SLA tracking, and escalation processes • Strong analytical skills with attention to detail • Familiarity with monitoring tools such as Dynatrace • Basic scripting knowledge for log review or automation • Awareness of ITIL practices • Understanding of US healthcare workflows including claims processing, member enrollment, and provider interactions • Familiarity with HIPAA compliance and healthcare data security standards Geographic Responsibility: Remote, US Type of Employment: Full-time, permanent Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  • The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus. • Work across multiple time zones in a hybrid or remote work environment. • Long periods of time sitting and/or standing in front of a computer using video technology. • May require travel dependent on company needs. The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check. HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. #LI-Remote ** The annual US base salary range for this position is $70,000 to $88,000 . This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.

Requirements

Must-haves

As a Healthcare IT Technical Operations Associate III (L2), you will be accountable for the following:
Investigate and triage job failures, fallouts, and reprocessing requests raised by L1
Perform initial analysis using application logs, database queries, monitoring tools, and upstream/downstream dependency checks to support root cause identification
Work alongside L3, product, and other stakeholders to drive root cause identification and resolution, providing analysis, context, and coordination throughout
Execute data correction and reprocess failed or fallout records per standard procedures once a fix or instruction is available
Validate outcomes after reprocessing and confirm successful completion
Support implementation of preventive actions for recurring failures in coordination with L3 and product teams
Perform record count reconciliation between input and output files, tables, and messages, and detailed reconciliation beyond basic counts as defined in the runbook
Execute periodic reconciliations across all interfaces to ensure end-to-end data integrity
Timely completion of adhoc customer requests
Analyze and resolve record count mismatches, data mismatches, duplicates, missing transactions, and out-of-balance conditions
Define and enhance reconciliation control mechanisms and validation checkpoints
Maintain reconciliation logs and audit trails for all data correction and reprocessing activity
Analyze inbound and outbound interface issues across systems
Coordinate with external vendors, trading partners, and upstream/downstream teams for file failures, format issues, delays, and data discrepancies
Provide functional guidance to L1 for complex monitoring and triage scenarios
Review L1-raised tickets for completeness and drive faster resolution
Contribute to runbook and SOP updates so recurring patterns are easier for L1 to detect, report, and route
Publish periodic reports on reconciliation status, fallout and reprocessing volumes, and SLA performance
Document and communicate open reprocessing activities, pending reconciliations, and business-critical risks during shift handover
Identify recurring failures and support permanent fixes and process improvements
Recommend automation opportunities for reconciliation and monitoring activities
Contribute to best practices and process standardization across interfaces
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

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Platform: icims
Effort: medium

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Health Insurance

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