Managed Care Applications Manager

Mediant Health Resources; Fort Worth (TX); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Mediant Health Resources is seeking a Senior Epic and MEDITECH Revenue Cycle Consultant to lead the integration and deployment of health plan applications, and to translate business requirements into scalable technical solutions.

You will oversee claims adjudication platforms, EDI/X12, CRM, data warehouses, and analytics tools, while mentoring technical staff and partnering with business teams to ensure security, compliance, and high performance.

Responsibilities

• Lead the development, integration, and deployment of health plan applications and system enhancements, ensuring solutions are delivered and operational
• Oversee core health plan systems including claims adjudication platforms, EDI/X12 transactions, CRM systems, data warehouses, and reporting/analytics tools
• Manage integrations between health plan systems, provider systems, and external partners using EDI, APIs, and HIE connectivity.
• Translate business and operational requirements into technical solutions while coordinating with enterprise architecture and infrastructure teams to meet security, compliance, and performance standards
• Evaluate existing applications and workflows to identify inefficiencies and implement system or process improvements that support health plan operations
• Manage and mentor technical staff, including hiring, performance management, and day-to-day team direction while partnering with business departments to support operational needs

Job description

• Lead the development, integration, and deployment of health plan applications and system enhancements, ensuring solutions are delivered and operational
• Oversee core health plan systems including claims adjudication platforms, EDI/X12 transactions, CRM systems, data warehouses, and reporting/analytics tools
• Manage integrations between health plan systems, provider systems, and external partners using EDI, APIs, and HIE connectivity.
• Translate business and operational requirements into technical solutions while coordinating with enterprise architecture and infrastructure teams to meet security, compliance, and performance standards
• Evaluate existing applications and workflows to identify inefficiencies and implement system or process improvements that support health plan operations
• Manage and mentor technical staff, including hiring, performance management, and day-to-day team direction while partnering with business departments to support operational needs

Senior Epic and MEDITECH Revenue Cycle Consultants