[Hiring] Manager Healthcare Claims Integration REMOTE USA
Position: Manager Healthcare Claims Integration
Date Posted: December 14, 2025
Industry: Healthcare / Health Informatics / Data Integration
Employment Type: Full Time
Experience: 5+ years in healthcare data integration, claims processing, or payer-provider data exchange
Qualification: Bachelor’s or Master’s degree in Health Informatics, Information Systems, Business/Statistics/Information Science, or related field
Salary: $116,000 – $130,000 plus 10% target bonus/variable compensation
Location: United States, REMOTE
Company: Personify Health
Description:
Personify Health is on a mission to simplify and personalize the health experience, helping companies improve employee health while reducing costs. We are seeking a strategic and technically skilled Manager of Healthcare Claims Integration to lead the end-to-end ingestion of healthcare claims data from multiple carriers into our enterprise systems. This role acts as a critical bridge between carriers, internal teams, and data platforms, ensuring accurate, timely, and compliant claims processing.
Key responsibilities include:
- Serve as primary liaison with healthcare carriers (medical, PBM, vision, dental) to establish and maintain data exchange partnerships
- Analyze inbound claims data feeds, identify validation or quality issues, and apply SQL and transformation logic for correction
- Manage mapping of carrier-specific data fields into the company’s universal data model, streamlining validation workflows
- Ensure claims data is accurately processed and integrated into internal systems, analytics tools, and dashboards
- Implement robust data validation, reconciliation, and quality control processes to maintain data integrity
- Mentor entry-level integration team members and execute strategic plans to scale ingestion capabilities
- Maintain comprehensive documentation, including business rules, file mappings, and transformation specifications
Candidate qualifications:
- Strong understanding of healthcare claims formats (EDI 837, NCPDP, proprietary formats) and coding standards (CPT, ICD, DRG)
- Proficiency in SQL, data warehousing, ETL tools, and cloud-based data platforms
- Experience managing external partnerships and cross-functional internal teams
- Expertise in data architecture, schema translation, data governance, and master data management (MDM)
- Excellent communication, project management, and problem-solving skills
- Experience with claims data reconciliation, migration projects, and analytics-focused organizations preferred
Benefits & Culture:
- Comprehensive medical, dental, vision, and mental health coverage
- Flexible work arrangements and unlimited PTO policy
- Retirement planning and voluntary benefits including Critical Illness and Hospital Indemnity
- Professional development, mentorship, and learning budget support
- Inclusive and collaborative work environment emphasizing diversity, equity, inclusion, and belonging
Personify Health fosters a mission-driven workplace that values innovation, accountability, and employee wellbeing. We encourage candidates from diverse backgrounds to apply and thrive in a culture focused on delivering meaningful health outcomes.
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