Payer Systems Manager

HealthTech Resources is seeking a Payer Systems Manager / Sr. Manager of HealthRules Payer Transaction Management for a direct hire role at a premier healthcare client in CA. Work will primarily be onsite near Fairfield, CA.

We are seeking an experienced senior manager with a strong background in HealthEdge HealthRules Payer claims systems and cloud-based technologies. This role will require hands-on technical work, so proven Java development skills are a must. In addition, the ideal candidate will have excellent people management and mentorship abilities, ensuring they can guide their team through any challenges they may face. We are looking for an IT leader who has successfully managed complex systems implementation projects, rather than someone with a pure business operations background. The right candidate will be comfortable blending technical expertise with project leadership responsibilities.

Primary Responsibilities

• Oversee and manage HRP Transaction Management functions, including leading a team, prioritizing tasks, and establishing standards
• Maintain comprehensive knowledge of HRP, its configuration, and integrations
• Understand and support PHC’s business domains, including membership, providers, authorizations, claims, and payments
• Manage HRP production schedules and transaction management support
• Collaborate with teams to support HRP system upgrades and regulatory requirements
• Lead projects and initiatives as assigned
• Develop policies, procedures, and documentation for the team

Key Qualifications

• Bachelor’s degree in Computer Science, Business, or a related field (Master’s preferred)
• 12+ years of IT experience in developing, implementing, and supporting software systems
• 8+ years of experience in a lead or management role, with 5+ in an IT department
• 3+ years managing a claims system with Java, Oracle, and UNIX experience
• 5+ years of experience in a healthcare environment
• Proficient in Java 8, Apache Camel, Spring Boot, XML, Maven, web services, Linux, and SQL
• Extensive experience with Oracle or SQL Server
• Proven leadership and people management skills
• Excellent verbal and written communication abilities

Opportunity Highlights

• Opportunity to lead a critical healthcare IT function
• Chance to work with a talented team and enhance your technical and leadership skills
• Potential for long-term growth within the organization