IT Systems & API Integration Manager

IT Systems & API Integration ManagerThe IT Systems & API Integration Manager is responsible for leading the organization's healthcare technology infrastructure, system integrations, and interoperability initiatives across the MSO and IPA operations. This role oversees API development, healthcare data exchange, system optimization, and automation to improve operational efficiency while ensuring secure, HIPAA-compliant integration between internal applications, health plans, EMRs, clearinghouses, and third-party vendors. The position partners closely with operations, finance, claims, provider network, quality, and executive leadership to support organizational growth and scalable technology solutions.

Essential Duties & Responsibilities

• Manage and support QuickCap system operations, maintenance, and troubleshooting

• Develop, maintain, and monitor API integrations between internal systems, health plans, clearinghouses, and vendors

• Support healthcare EDI transactions including:

• 837 Claims

• 835 Remittance

• 270/271 Eligibility

• 278 Authorization

• 834 Enrollment files

• Assist with provider roster management, membership files, capitation reports, and claims data imports/exports

• Coordinate system integrations with health plans, MSOs, EMRs/EHRs, laboratories, and third-party vendors

• Work with operations, claims, contracting, credentialing, and quality departments to improve workflows and automation

• Troubleshoot system issues related to eligibility, authorizations, claims, encounters, and provider data

• Create reports, dashboards, and automated data processes using SQL, Excel, or reporting tools

• Monitor data integrity and ensure HIPAA compliance and data security standards are maintained

• Support system upgrades, testing, implementation, and user training

• Document technical processes, workflows, APIs, and integration specifications

• Collaborate with vendors and internal leadership on IT initiatives and operational improvements

• Assist with population health, RAF/HCC, quality measure, and care gap data integrations when needed

Qualifications

Education

• Bachelor's degree in Information Technology, Computer Science, Healthcare Informatics, or related field preferred

Required Experience

• Minimum 3-4 years of IT experience within:

• IPA

• MSO

• Managed Care

• Health Plan

• Medical Group environment

• Hands-on experience with QuickCap strongly preferred

• Experience working with APIs, system integrations, and healthcare data exchange

• Understanding of healthcare EDI formats and managed care operations

• Knowledge of claims processing, eligibility, provider data, and capitation workflows

• Experience with SQL queries, database management, and reporting tools

• Familiarity with HIPAA compliance and healthcare data security standards

• Strong analytical, troubleshooting, and problem-solving skills

• Excellent communication and project coordination abilities

• Ability to manage multiple projects and deadlines in a fast-paced healthcare environment

Preferred Skills/Experience

• Experience with:

• HL7/FHIR integrations

• API platforms

• Clearinghouse integrations

• Population health systems

• Cozeva or healthcare analytics platforms

• Microsoft SQL Server

• Power BI or Tableau

• Understanding of Medicare Advantage and Medi-Cal managed care operations

• Experience supporting delegated healthcare environments

Preferred Certifications

• CompTIA A+, Network+, or Security+ certification preferred.
• Microsoft SQL, Azure, or related database certification preferred.
• Healthcare Information and Management Systems Society (HIMSS) preferred certification.
• Relevant API, interoperability, or healthcare IT certifications preferred.

Compensation & Benefits

• Competitive salary based on experience ($85k - $125K)
• Health, dental, and vision insurance
• Paid time off and holidays
• Career growth opportunities within a growing healthcare organization
• Collaborative and mission-driven work environment

Work Location

• On-site - Alhambra, California

Job Type

• Full-time