Healthcare Data Integration Specialist

Alera Group•UNAVAILABLE, UNAVAILABLE

3d•Remote

About The Position

The Integration Specialist is an exempt highly skilled individual contributor responsible for executing and optimizing complex healthcare data integrations. This role partners closely with the Director of Data Integration, Integration Team Lead, and cross-functional teams to ensure the accurate, timely, and complete integration of healthcare data. This position requires deep familiarity with healthcare data (including medical and Rx claims), strong analytical capabilities, and the ability to independently manage integration workflows, resolve data issues, and drive process improvements. The ideal candidate brings both technical expertise and operational ownership to support high-quality data delivery across the organization.

Requirements

Bachelor’s degree in Healthcare, Data Analytics, Computer Science, Information Systems, or a related field (or equivalent experience)
Minimum 4 years of hands-on experience working with healthcare data, including claims, eligibility, pharmacy, clinical, or related healthcare datasets
Experience within the healthcare payer, third-party administrator (TPA), pharmacy benefit manager (PBM), or healthcare analytics industry strongly preferred
Proven ability to analyze and interpret complex healthcare datasets and quickly apply business and data domain knowledge in a healthcare environment
Hands-on experience with data integration, data validation, data operations, or data quality management
Experience working with external data sources, vendors, or data partners
Strong Excel skills (data manipulation, validation, and analysis)
Strong SQL and data analysis skills
Familiarity with healthcare data structures, file layouts, data mapping, and integration concepts
Familiarity with industry-standard healthcare data formats and transactions (e.g., HIPAA X12, HL7)
Strong analytical and problem-solving skills
High attention to detail and commitment to data quality
Excellent organizational skills with the ability to manage multiple priorities
Effective communicator across technical and non-technical audiences
Self-motivated with the ability to work independently and adapt quickly in a fast-paced environment

Nice To Haves

Experience leveraging AI-enabled tools or technologies is a plus

Responsibilities

Lead execution of complex healthcare data integrations, including intake, analysis, mapping support, and validation
Evaluate incoming data formats (standard and non-standard) and identify requirements for successful integration
Perform detailed file analytics to assess data completeness, structure, and usability
Support mapping efforts and ensure alignment with reporting and downstream data needs
Identify, investigate, and resolve data anomalies, gaps, and inconsistencies in healthcare datasets
Perform control comparisons and validation checks to ensure data accuracy and integrity
Collaborate with internal teams and external data providers to resolve complex data issues
Escalate critical risks or issues appropriately while driving toward resolution
Support the monitoring and maintenance of recurring data feeds and associated data quality issues
Identify breakdowns or inefficiencies in file transmission process and recommend improvements.
Analyze trends in data issues and recommend solutions to improve consistency and completeness
Ensure timely resolution of data discrepancies impacting reporting and analytics
Identify opportunities to improve integration workflows, data quality processes, and operational efficiency
Contribute to the development and maintenance of integration documentation, standards, and best practices
Support enhancements to tracking, ticketing, and communication processes
Partner with Data, Technology, and Strategy teams to ensure alignment on integration requirements and outcomes
Communicate integration progress, risks, and dependencies clearly to stakeholders
Build effective working relationships with external data providers to facilitate data acquisition and issue resolution