About the role
IT Systems & API Integration Manager The purpose of the IT Systems & API Integration Specialist is to support and optimize the organization’s healthcare technology infrastructure, system integrations, and data exchange processes to ensure efficient operations across the IPA/MSO environment. This position is responsible for maintaining and enhancing QuickCap and related healthcare systems, developing API integrations, improving data accuracy and automation, and supporting operational departments including claims, eligibility, contracting, credentialing, quality, and population health. The role helps ensure timely and secure exchange of healthcare data while supporting organizational growth, compliance, and operational efficiency within managed care and value-based healthcare programs.
JOB TYPE & WORK LOCATION
On-site – Alhambra, California
Full-time
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
REQUIRED QUALIFICATIONS
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
EDUCATION
Bachelor’s degree in Information Technology, Computer Science, Healthcare Informatics, or related field preferred
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.
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