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Sr Implementation Consultant

Job in San Jose, Santa Clara County, California, 95199, USA
Listing for: Cotiviti
Full Time position
Listed on 2026-08-06
Job specializations:
  • IT/Tech
    IT Consultant, Systems Analyst
Salary/Wage Range or Industry Benchmark: 100000 - 145000 USD Yearly USD 100000.00 145000.00 YEAR
Job Description & How to Apply Below

Overview

The Senior Implementation Consultant assists in the testing and implementation of Edifecs’ solutions purchased by that client. The Implementation Consultant will generally be involved in installing & configuring under the direction of the Technical Project Manager and/or Implementation/Solution Architect. This includes installation of products on client hardware; configuration and development of programs, tasks and guidelines, and setup to fully implement an Edifecs solution.

Duties can range from delivery of product training to new client specific requirements, development and deployment. The role involves client coordination and communication as well as technical understanding of Edifecs’ solutions and the transactions that flow through this position.

Responsibilities
  • Implement and configure Edifecs applications for payer systems on AWS, Azure cloud or virtual machines.
  • Implement and manage integrations between Edifecs’ products and solutions and Customer’s on-premise systems.
  • Analyze business requirements and translate them into technical configurations, workflows, and mapping documents.
  • Develop and test real-time and batch integrations using:
    • EDI (X12: 834, 837, 835, 270/271, 276/277, 278)
    • FHIR (CMS Interoperability APIs)
    • HL7 v2/v3
  • Implement service-based integrations via RESTful APIs, SOAP Web Services, ESBs, and iPaaS platforms.
  • Create mapping specifications and perform data validation, reconciliation, and error resolution.
  • Support ETL processes and legacy data migration to new payer systems.
  • Perform data profiling, cleansing, transformation, and loading activities.
  • Assist QA teams with creating technical test cases and validating system configurations and interfaces during SIT/UAT.
  • Partner with business analysts, SMEs, solution architects and delivery leads to ensure alignment of technical deliverables.
  • Develop appropriate training and development plans to meet the client’s particular maintenance level and to configure the software according to the project plan.
  • Provide post-implementation support during the transition from implementation to maintenance.
  • Provide software and client specific training and develop training documentation based on present standards and client needs.
  • Participate in design workshops, integration sessions, and go-live readiness planning.
  • Provide technical guidance to junior implementation staff and contribute to solution documentation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications
  • Bachelor’s in computer science, Information Technology, Information Systems or other technology related degree or equivalent experience in implementing, and operating Java stack-based enterprise applications.
  • 5+ years of experience in technical healthcare system implementation, preferably with a payer or health plan.
  • 3+ years of experience with Electronic Data Interchange (EDI) mapping and EDI analysis.
  • Deep understanding of X12 standards, FHIR and other standards based interoperability / integration patterns in the Healthcare Industry.
  • Hands on experience in analyzing transactions and creating interfaces for transactions such as X12 837, 835, 834, proprietary formats and deep knowledge of coding standards such as LOINC, SNOMED, ICD 10.
  • Familiarity with data formats: JSON, XML, HL7v2 messages, X12, flat files (CSV, pipe-delimited, etc.).
  • Strong knowledge of Edifecs Applications.
  • Decent knowledge of healthcare EDI transactions (834, 837, 835, 270/271, 278).
  • Proficiency in data modeling (logical & physical) and relational databases (SQL Server, Oracle)
  • Experience implementing solutions on AWS, Azure using CI/CD pipelines (Git Lab, Jenkins, Terraform, Cloud Formation).Experience working in Agile or SAFe environments.
  • Working knowledge of java programming language and good understanding of SOAP and REST based web services.
  • Prior experience troubleshooting performance problems that may have many…
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