Technical Implementation Integration Lead - (Healthcare Claims)

About Avalon Healthcare Solutions :

Avalon Healthcare Solutions is the nation’s leader in diagnostic intelligence, uniquely focused on transforming the role of diagnostic testing across the healthcare ecosystem. Our proprietary Diagnostic Insights Platform delivers evidence-based policies, curated lab networks, and real-time analytics that simplify complex diagnostics, accelerate innovation adoption, and optimize diagnostic investments.

Supporting over 30 health plans and 100 million members nationwide, Avalon partners with payers and providers to ensure diagnostic testing is performed appropriately, efficiently, and at the right time. Our flexible solutions span routine and genetic testing management, automated adherence, and end-to-end diagnostics support—driving measurable value, reduced waste, and improved clinical outcomes.

With unmatched scientific rigor, deep clinical expertise, and a performance-based model, Avalon is redefining how diagnostics power personalized care and healthcare value. You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit 

Avalon Healthcare Solutions is an Equal Opportunity Employer - Vet/Disability.

This position description is subject to change at any time. As determined by the company based upon business needs, an employee in this position may be required to perform duties and take responsibility for work other than as described in this document.

About the Technical Implementation Integration Lead (Healthcare Claims) Position :

The Technical Implementation Integration Lead plays a critical role in the successful implementation of Avalon’s Lab Benefit Management (LBM) programs by managing all technical integration points between Avalon systems and client platforms. Serving as both a client-facing technical subject matter expert and an internal liaison, this role partners with Information Technology, Product, Configuration, Development, and Implementation teams to ensure seamless system connectivity, data exchange, configuration, and operational readiness.

This position leads technical integration activities throughout the implementation lifecycle, from pre-sales engagement through post-production stabilization, ensuring all integration requirements are defined, validated, and executed in alignment with project timelines and quality standards. Leveraging expertise in healthcare operations, business analysis, technical project coordination, and data management, the incumbent drives cross-functional collaboration, manages implementation risks, and delivers high-quality integration solutions that support client success and organizational objectives.

Success in this role requires balancing technical execution, stakeholder engagement, operational priorities, and project governance while optimizing implementation processes, ensuring compliance with business and technical requirements, and serving as a trusted partner to internal and external stakeholders throughout the implementation process.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Technical Implementation Integration Lead (Healthcare Claims) – Essential Functions and Responsibilities :

Serve as the client-facing subject matter expert on all aspects of technical integration delivery. Capable of discussions with client IT resources, client operations staff and program intermediaries in their terms.Manage concurrent client implementations with complex business requirements across Pre-Pay and Post-Pay data exchanges, configurations, validations, and production readiness with minimal oversight.Work with Project team to Develop and execute implementation plans for projects and initiatives, ensuring that all stakeholders are informed and engaged throughout the process.Ensure successful implementation of Avalon’s LBM programs by managing technical integration activities around onboarding tasks, technical requirements gathering, development, testing, and deployment phases.Lead and document data mapping and GAP analysis sessions for program data files and extracts with clients and intermediaries.Maintain traceability for technical risks, issues, assumptions, decisions, owners, impacts, and possible mitigations plans.Work with Delivery Owners and Project Managers to escalate unresolved technical risks, defects, and data quality issues, which may impact the implementation. Collaborate with internal Avalon teams to define and clarify technical requirements, and ensure timely execution of deliverables aligned with project timelines. Coordinate setup of secure system access (e.g., SSO, SFTP) for client users and providers.Create and manage technical work items (e.g., JIRA tickets) for development and configuration tasks.Generates reports and dashboards utilizing bi-tools such as TableauSupport end-to-end user acceptance testing (UAT), including planning, execution, and issue resolution.Performing data validations and data analysis, using SQL tools to generate complex queries for research and testing.Translate business needs into clear functional and technical specifications for development and testing teams, while effectively communicating technical requirements, solutions, and issues to business stakeholders in a clear and actionable manner.Collaborate with internal and external stakeholders to identify, develop, and deliver process improvements that enhance efficiency and project quality, reducing overall implementation timelinesAct as a business owner of all technical integration-related materials within the Avalon Implementation Toolkit, including the Implementation Guide and supplemental specifications.Identify and drive process and solution improvements to enhance implementation efficiency, shorten delivery time and reduce defects while never compromising on qualitySupport and Author Technical Integration documentation and process flows.

Technical Implementation Integration Lead – Minimum Qualifications :

Minimum of five (5) years’ professional implementation experience in some combination of IT integration or electronic data exchange (EDI) in health care operations.Minimum of three (3) years, supporting medical claim processing technologies in a health plan, managed care, or benefits management industry.Ability to skillfully negotiate and resolve issues between external and internal stakeholders.Solid understanding of the software development lifecycle, technical implementation best practices, and testing methodologies. Can work equally in a Waterfall or Agile environment.Experience supporting healthcare data integrations, including EDI, HL7, FHIR, or other healthcare interoperability standards.Proven ability to elicit, analyze, and translate business, technical, and integration requirements into effective implementation solutions.Demonstrated success managing client-facing technical implementations within a health plan, managed care, or healthcare benefits environment.Bachelor's degree in Information Technology, Computer Science, Health Informatics, Business Administration, or a related field.Experience utilizing project tools such as JIRA, Confluence and Smartsheet.Expertise in SQL and Tableau

Technical Implementation Integration Lead – Preferred Qualifications :

Previous experience in a small, high-growth company. Utilization Management and prior authorization pr ocessing e xperience Experience with Snowflake

PM18

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