Provider Data Remote Jobs (NOW HIRING)

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

WE WILL NOT CONSIDER REMOTE CANDIDATES!

THIS IS A HYBRID, OFFICE BASED POSITION WORKING AT OUR ELLIS PRESERVE OFFICE LOCATED IN NEWTOWN SQUARE, PA 

OFFICE DAYS ARE 3 DAYS PER WEEK (TUESDAY, WEDNESDAY AND THURSDAY); REMOTE DAYS ARE MONDAY AND FRIDAY

Role Overview

The Manager Data Integration will lead the planning, design, and execution of data integration initiatives that enable interoperable, high-quality, and compliant data flows across payer and provider systems. This role will support HIE, FHIR, USCDI, HEDIS, quality, and regulatory reporting programs, ensuring accurate, timely, and governed data for analytics, operations, and compliance. 

Responsibilities 

Team Leadership & Development: Lead, mentor, and develop a high-performing IT team, fostering a culture of engagement, collaboration, continuous improvement, and professional growth. Demonstrate ability to execute under multiple sourcing models. Establish and maintain succession plans. Demonstrate ability to effectively manage performance in a manner that optimizes cost and productivity performance.

• Lead a team of data integration engineers and analysts, managing workload, priorities, and development
• Coordinate with Data Architects, Data Stewards, and Business SMEs to ensure consistent standards and practices
• Mentor team members on interoperability standards, data quality practices, and healthcare reporting requirements

IT Operations Management: Oversee the daily operations of IT systems, networks, and applications, ensuring optimal performance, reliability, availability, and efficiencies within area of responsibility. Manage department-level IT applications and capabilities that support functional and operating groups including year-over-year maintenance costs, enhancements, and initiatives or projects.

• Prepare and validate data for HEDIS, STAR, CMS, NCQA, and state regulatory submissions
• Ensure data quality, completeness, and lineage for regulatory and quality reporting
• Collaborate with Data Governance and Quality teams to resolve integration and reporting issues
• Enforce data integration standards, coding conventions, and documentation practices
• Collaborate with governance teams to maintain metadata, lineage, and catalog compliance in tools like Alation or Collibra
• Identify opportunities for process automation and optimization in data integration workflows

Project Management: Manage IT initiatives from conception to completion, including cost and scheduled estimates, system implementations, upgrades, and migrations, ensuring projects are delivered on time, within budget, and in compliance with business case and quality expectations. Identify risks and drive successful mitigation approaches. Demonstrate competency in Agile and related development approaches including ability to effectively engaged product owners.

• Design, develop, and maintain data integration pipelines for claims, clinical, eligibility, and provider data
• Implement HL7, FHIR, X12, CCD, and USCDI standards to enable secure, compliant data exchange
• Collaborate with HIE partners and internal teams to onboard, validate, and manage external data feeds
• Support development of FHIR APIs and SMART on FHIR applications for downstream analytics and reporting

Security & Compliance:  Establish and enforce robust cybersecurity protocols and data privacy measures, ensuring compliance with all relevant healthcare regulations (e.g., HIPAA, HITECH, state-specific mandates). 

Vendor Management:  Manage relationships with third-party IT vendors and service providers, negotiating contracts, ensuring service level agreements (SLAs) are met, and optimizing vendor performance. 

Financial Management:  Establish and manage assigned operating and capital expense budgets. Demonstrate capability to manage staffing based on a combination of year-over-year run-the-business expense and projects including the use of contingent staff and sourcing models to meet variable staffing needs. Analyze and remediate variances. Work with program and project managers to establish, manage, and meeting project financial and business-case objectives. 

Innovation & Technology Adoption:  Maintains awareness of new technologies and solutions that can enhance department capabilities. Make recommendations on new technologies as appropriate. 

Disaster Recovery & Business Continuity:  Maintain comprehensive disaster recovery and business continuity plans for critical, in-scope IT systems. 

Business Partner and Stakeholder Collaboration:  Collaborate effectively with other departments and external partners.

Education and Experience

• At least three to five (3 to 5) years  of Enterprise Architect experience
• At least three to five (3 to 5) years of experience managing technical teams of 5 - 10 employees
• Experience in Azure Data Platform (ADF, Databricks), Snowflake, or equivalent cloud platforms
• Hands-on experience with HEDIS, STAR, CMS, NCQA, or state reporting preferred
• Strong knowledge of HL7, FHIR, X12, CCD, USCDI standards
• Understanding of HIPAA, HITRUST, and data security/compliance requirements
• Bachelor’s Degree preferred or equivalent experience
   

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. 

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.