Job Description

Project description
5-7 years of experience in Monitor and support provider-related applications (credentialing, network management, provider portals). 5-7 years of experience in Handle incident resolution, root cause analysis, and ensure minimal disruption to provider services.
Responsibilities

• Monitor and support provider-facing applications (e.g., credentialing, network management, provider portals), ensuring high availability, performance, and a reliable user experience. Own incident management end-to-end: triage, troubleshoot, resolve issues; perform root cause analysis (RCA); implement corrective and preventive actions (CAPA) to minimize service disruption. Manage deployments and releases for provider applications: coordinate release readiness, perform smoke/sanity checks, and drive post-release validation. Administer and maintain test environments (DEV/UAT/SIT): ensure environment parity, data refreshes, configuration management, and test support. Oversee provider onboarding, credentialing, and enrollment workflows within applications, optimizing process efficiency and accuracy. Ensure regulatory compliance across workflows and data handling, adhering to HIPAA, CMS guidelines, and NCQA standards; maintain robust access controls and audit trails. Safeguard data integrity and quality: validate provider data, manage reconciliations, and enforce governance rules across integrations and interfaces. Collaborate cross-functionally with Product, Engineering, QA, Security, and Operations to deliver features, resolve defects, and improve the provider experience. Document operational procedures: build and maintain runbooks, SOPs, RCA reports, and release notes for consistent, compliant operations. Identify and drive continuous improvements in monitoring, automation, and workflow optimization to reduce incidents and improve time-to-resolution.

SKILLS
Must have

• Application Support & Monitoring: Strong experience in supporting provider-related applications (credentialing, network management, provider portals). Ability to monitor application health, performance, and availability. Incident Management & Root Cause Analysis: Expertise in troubleshooting, resolving incidents, and performing RCA. Familiarity with ITIL processes (Incident, Problem, Change Management). Deployment & Release Management: Hands-on experience with application deployment, release coordination, and environment management (DEV/UAT/PROD). Knowledge of CI/CD tools and processes. Provider Workflow Management: Understanding of provider onboarding, credentialing, and enrollment workflows. Ability to configure and maintain these workflows in applications. Regulatory Compliance: Knowledge of healthcare regulations: HIPAA, CMS, NCQA. Experience ensuring compliance and maintaining audit trails. Data Integrity & Governance: Skills in validating provider data, managing reconciliations, and ensuring data accuracy. Technical Skills: SQL for data queries and troubleshooting. Familiarity with APIs, integrations, and interface monitoring. Basic scripting (e.g., PowerShell, Python) for automation. Communication & Collaboration: Strong ability to work with cross-functional teams (Product, QA, Engineering). Clear documentation skills (SOPs, RCA reports, release notes). Tools & Platforms: Experience with ticketing systems (ServiceNow, JIRA). Monitoring tools (Splunk, AppDynamics, or similar). Healthcare provider systems (e.g., CAQH, Facets, HealthRules, or similar).

Nice to have
ITIL Foundation. HIPAA Compliance Training. Healthcare IT certifications (e.g., CPHIMS).

Skills Required