IT Systems & API Integration Manager

IT Systems & API Integration ManagerThe purpose of the IT Systems & API Integration Specialist is to support and optimize the organization’s healthcare technology infrastructure, system integrations, and data exchange processes to ensure efficient operations across the IPA/MSO environment. This position is responsible for maintaining and enhancing QuickCap and related healthcare systems, developing API integrations, improving data accuracy and automation, and supporting operational departments including claims, eligibility, contracting, credentialing, quality, and population health. The role helps ensure timely and secure exchange of healthcare data while supporting organizational growth, compliance, and operational efficiency within managed care and value-based healthcare programs.JOB TYPE & WORK LOCATIONOn-site – Alhambra, CaliforniaFull-timeESSENTIAL DUTIES & RESPONSIBILITIESManage and support QuickCap system operations, maintenance, and troubleshootingDevelop, maintain, and monitor API integrations between internal systems, health plans, clearinghouses, and vendorsSupport healthcare EDI transactions including:837 Claims835 Remittance270/271 Eligibility278 Authorization834 Enrollment filesAssist with provider roster management, membership files, capitation reports, and claims data imports/exportsCoordinate system integrations with health plans, MSOs, EMRs/EHRs, laboratories, and third-party vendorsWork with operations, claims, contracting, credentialing, and quality departments to improve workflows and automationTroubleshoot system issues related to eligibility, authorizations, claims, encounters, and provider dataCreate reports, dashboards, and automated data processes using SQL, Excel, or reporting toolsMonitor data integrity and ensure HIPAA compliance and data security standards are maintainedSupport system upgrades, testing, implementation, and user trainingDocument technical processes, workflows, APIs, and integration specificationsCollaborate with vendors and internal leadership on IT initiatives and operational improvementsAssist with population health, RAF/HCC, quality measure, and care gap data integrations when neededREQUIRED QUALIFICATIONSMinimum 3–4 years of IT experience within:IPAMSOManaged CareHealth PlanMedical Group environmentHands-on experience with QuickCap strongly preferredExperience working with APIs, system integrations, and healthcare data exchangeUnderstanding of healthcare EDI formats and managed care operationsKnowledge of claims processing, eligibility, provider data, and capitation workflowsExperience with SQL queries, database management, and reporting toolsFamiliarity with HIPAA compliance and healthcare data security standardsStrong analytical, troubleshooting, and problem-solving skillsExcellent communication and project coordination abilitiesAbility to manage multiple projects and deadlines in a fast-paced healthcare environmentPREFERRED SKILLS/EXPERIENCEExperience with:HL7/FHIR integrationsAPI platformsClearinghouse integrationsPopulation health systemsCozeva or healthcare analytics platformsMicrosoft SQL ServerPower BI or TableauUnderstanding of Medicare Advantage and Medi-Cal managed care operationsExperience supporting delegated healthcare environmentsEDUCATIONBachelor’s degree in Information Technology, Computer Science, Healthcare Informatics, or related field preferredPREFERRED CERTIFICATIONSCompTIA A+, Network+, or Security+ certification preferred.Microsoft SQL, Azure, or related database certification preferred.Healthcare Information and Management Systems Society (HIMSS) preferred certification.Relevant API, interoperability, or healthcare IT certifications preferred.#JM0625 #J-18808-Ljbffr Alhambra EP, LLC