The work- Triage, diagnose and resolve production incidents across clinical and provider-facing applications, against defined response and resolution targets.
- Work a high-volume inbound support queue - classifying, resolving or routing each request.
- Investigate prior authorization exceptions, tracing them from the inbound transaction through to the application record.
- Determine whether a fault sits in in-house code or in a vendor product, and escalate with the evidence to support it.
- Produce root cause analysis and knowledge base articles on closure.
Essential - SQL - Oracle and SQL Server, at a level that supports independent investigation.
- Java and web services - reading application code, interpreting application server logs, and testing SOAP and REST endpoints with SOAP UI or Postman.
- EDI X12 278 - prior authorization request and response, including the ability to read raw segment content. 834, 837 and 835 exposure is useful.
- ITSM tooling - Ivanti Neurons, Cherwell, ServiceNow or equivalent, working to severity-based targets.
- 8:00am-6pm ET, with participation in an on-call rote
- 5-8 years in application support, including 3+ in healthcare payer systems
- V2Soft office, Michigan - on-site
Strongly preferred - Cognizant CareAdvance - hands-on support or configuration experience with the care and utilization management platform, and with CareAdvance Provider for provider-facing prior authorization. This is the single strongest differentiator for these roles.
lso relevant - Other commercial care or utilization management platforms - Cognizant TriZetto Facets or QNXT, HealthEdge GuidingCare, ZeOmega Jiva, Altruista, or an equivalent in-house UM/CM system.
- Clearinghouse integration; FHIR; CMS interoperability awareness.
https://www.v2soft.com/careers - to view all of our open opportunities and to learn more about our benefits.
