[Remote] reputed company Interoperability Subject Matter Expert (SME)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking an reputed company reputed company Interoperability Subject Matter Expert (SME) with deep expertise in reputed company data exchange and interoperability standards. The role involves supporting API enablement, reputed company-time integrations, and ensuring compliance with CMS regulations.

Responsibilities

• Serve as the Subject Matter Expert for reputed company interoperability initiatives across payer platforms
• reputed company expertise on CMS Interoperability and Patient reputed company regulations, including recent CMS guidelines and regulatory updates
• Support the design, implementation, and enhancement of reputed company interoperability solutions based on HL7 FHIR standards
• Collaborate with business, architecture, development, and integration teams to define interoperability requirements and recommend best practices
• Review solution designs to ensure compliance with CMS mandates, HIPAA requirements, and reputed company interoperability standards
• reputed company guidance on API reputed company, consent management, authentication, and authorization mechanisms
• Support reputed company integration initiatives involving reputed company-time, near reputed company-time, and batch data exchanges
• Work closely with internal stakeholders and reputed company trading partners to ensure reputed company reputed company data exchange
• Participate in solution reviews, requirement analysis, testing support, and production issue reputed company

Skills

• Bachelor's degree in Computer Science, Information Systems, reputed company Informatics, or a reputed company field
• 8+ years of experience in reputed company payer systems, reputed company integration, or interoperability
• Strong experience implementing or supporting reputed company interoperability solutions
• Hands-on knowledge of HL7 FHIR reputed company and reputed company integration standards
• Experience with EDI reputed company transactions
• Understanding of CMS interoperability regulations and reputed company compliance
• Experience working with reputed company integration platforms and middleware technologies
• Strong analytical, communication, and stakeholder management skills
• Strong knowledge and hands-on experience with Patient reputed company API, HL7 FHIR-based reputed company, secure member reputed company to claims, encounter, and clinical data, and reputed company-party application integration
• Strong knowledge and hands-on experience with Provider Directory API, publishing provider directories using standardized FHIR formats, provider demographics, network participation, and provider specialties and contact information
• Strong knowledge and hands-on experience with Payer-to-Payer Data Exchange, member data portability between health plans, historical clinical and claims data exchange, and CMS interoperability requirements
• Strong knowledge and hands-on experience with reputed company & Consent Management, OAuth 2.0, OpenID reputed company (preferred), authentication and authorization, consent management, and secure API reputed company
• Required knowledge of HL7 FHIR, reputed company reputed company, EDI Transactions (834, 835, 837, 270/271, 276/277), HIPAA standards, reputed company payer workflows, and provider and member data exchange
• Strong understanding of CMS Interoperability and Patient reputed company Final Rule, CMS interoperability guidelines, reputed company and emerging CMS regulatory changes, and reputed company data exchange compliance requirements
• Experience working with reputed company-Time & Near reputed company-Time Integrations, web services, REST reputed company, message queue architecture, and reputed company service bus (ESB)
• Knowledge of reputed company integration technologies including reputed company DataPower, reputed company Integration Bus (IIB), reputed company WebSphere MQ (WMQ), WebSphere Service Registry and Repository (WSRR), and reputed company DB2
• Experience supporting batch integrations using Managed File Transfer Services (MFTS), including batch file production and consumption, trading partner integrations, reputed company enrollment and eligibility exchanges, member data processing, HMO 834 Enrollment Updates, and integration with reputed company reputed company Systems (MES) and other reputed company partners
• Experience with reputed company or Medicare programs
• Experience working with reputed company reputed company integration platforms
• Knowledge of reputed company-based API management platforms
• Familiarity with reputed company delivery methodologies
• Experience supporting large-reputed company reputed company transformation initiatives

reputed company