IT Systems & API Integration Manager

Tyvan LLC•Remote - California, CA

1d•$85,000 - $125,000•Onsite

About The Position

The 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.

Requirements

Bachelor’s degree in Information Technology, Computer Science, Healthcare Informatics, or related field preferred
Minimum 3–4 years of IT experience within IPA, MSO, Managed Care, Health Plan, or 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

Nice To Haves

Experience with HL7/FHIR integrations
Experience with API platforms
Experience with Clearinghouse integrations
Experience with Population health systems
Experience with Cozeva or healthcare analytics platforms
Experience with Microsoft SQL Server
Experience with Power BI or Tableau
Understanding of Medicare Advantage and Medi-Cal managed care operations
Experience supporting delegated healthcare environments
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

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