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Nutex Health
Posted 5 days agoVerified live 1d ago

IT Systems & API Integration Manager

Brief overview

Remote
UndergradOr in progress
3+ yrsMinimum
QuickCapAPI IntegrationHealthcare Data ExchangeHealthcare EDI TransactionsSQLHIPAA ComplianceClaims ProcessingEligibility and Provider Data ManagementCapitation WorkflowsHL7/FHIR IntegrationMicrosoft SQL ServerPower BITableauCozevaManaged Care OperationsProject Coordination

About the company

N
Nutex Healthnutexhealth.com

Nutex Health is a service provider and management firm in the Micro-hospital and Freestanding Emergency Room (FSER) industry. It is a sub-organization of Royse City Emergency Hospital.

Job description

Summary

Nutex Health is seeking an IT Systems & API Integration Manager to support and optimize healthcare technology infrastructure, system integrations, and data exchange processes. The role manages QuickCap and related healthcare systems, develops API integrations, improves data accuracy and automation, and supports operational departments across managed care and value-based healthcare programs.

Responsibilities

  • Manage and support QuickCap system operations, maintenance, and troubleshooting
  • Develop, maintain, and monitor API integrations between internal systems, health plans, clearinghouses, and vendors
  • Support healthcare EDI transactions including: + 837 Claims + 835 Remittance + 270/271 Eligibility + 278 Authorization + 834 Enrollment files
  • Assist with provider roster management, membership files, capitation reports, and claims data imports/exports
  • Coordinate system integrations with health plans, MSOs, EMRs/EHRs, laboratories, and third-party vendors
  • Work with operations, claims, contracting, credentialing, and quality departments to improve workflows and automation
  • Troubleshoot system issues related to eligibility, authorizations, claims, encounters, and provider data
  • Create reports, dashboards, and automated data processes using SQL, Excel, or reporting tools
  • Monitor data integrity and ensure HIPAA compliance and data security standards are maintained
  • Support system upgrades, testing, implementation, and user training
  • Document technical processes, workflows, APIs, and integration specifications
  • Collaborate with vendors and internal leadership on IT initiatives and operational improvements
  • Assist with population health, RAF/HCC, quality measure, and care gap data integrations when needed

Skills

  • Minimum 3–4 years of IT experience within: + IPA + MSO + Managed Care + Health Plan + Medical Group environment
  • Experience working with APIs, system integrations, and healthcare data exchange
  • Understanding of healthcare EDI formats and managed care operations
  • Knowledge of claims processing, eligibility, provider data, and capitation workflows
  • Experience with SQL queries, database management, and reporting tools
  • Familiarity with HIPAA compliance and healthcare data security standards
  • Strong analytical, troubleshooting, and problem-solving skills
  • Excellent communication and project coordination abilities
  • Ability to manage multiple projects and deadlines in a fast-paced healthcare environment
  • Hands-on experience with QuickCap strongly preferred
  • Experience with: + HL7/FHIR integrations + API platforms + Clearinghouse integrations + Population health systems + Cozeva or healthcare analytics platforms + Microsoft SQL Server + Power BI or Tableau
  • Understanding of Medicare Advantage and Medi-Cal managed care operations
  • Experience supporting delegated healthcare environments
  • Bachelor's degree in Information Technology, Computer Science, Healthcare Informatics, or related field preferred
  • CompTIA 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

Qualifications

Must Haves

  • Minimum 3–4 years of IT experience within: + IPA + MSO + Managed Care + Health Plan + Medical Group environment
  • Experience working with APIs, system integrations, and healthcare data exchange
  • Understanding of healthcare EDI formats and managed care operations
  • Knowledge of claims processing, eligibility, provider data, and capitation workflows
  • Experience with SQL queries, database management, and reporting tools
  • Familiarity with HIPAA compliance and healthcare data security standards
  • Strong analytical, troubleshooting, and problem-solving skills
  • Excellent communication and project coordination abilities
  • Ability to manage multiple projects and deadlines in a fast-paced healthcare environment

Nice to Haves

  • Hands-on experience with QuickCap strongly preferred
  • Experience with: + HL7/FHIR integrations + API platforms + Clearinghouse integrations + Population health systems + Cozeva or healthcare analytics platforms + Microsoft SQL Server + Power BI or Tableau
  • Understanding of Medicare Advantage and Medi-Cal managed care operations
  • Experience supporting delegated healthcare environments
  • Bachelor's degree in Information Technology, Computer Science, Healthcare Informatics, or related field preferred
  • CompTIA 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

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