Company Description
Clearlink Partners is an industry-leading managed care consultancy specializing in end-to-end clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special Needs Plans, complex care populations, and risk-adjusted entities.
We support organizations as they navigate a dynamic healthcare ecosystem by helping them manage risk, optimize healthcare spend, improve member experience, accelerate quality outcomes, and promote health equity.
Position Responsibilities
- Design, develop, and maintain COBOL-based applications with embedded SQL for DB2 databases.
- Create, optimize, and monitor system interfaces and data processing for claims, providers, members, authorizations, and encounters.
- Support and enhance the underlying infrastructure running on Unix AIX platforms, including Unix shell scripting enhancements and deployment processes.
- Innovate and improve core system capabilities aligned with operational needs and regulatory requirements.
- Lead initiatives to modernize EDI transactions and other mission-critical data exchanges, including standards such as 834, 837, and 278.
- Coordinate and manage program change requests with internal users and external vendors.
- Troubleshoot, document, and resolve errors and bugs within claims/eligibility systems and internally developed software.
- Establish and refine standardized testing processes and manage testing and implementation for new software releases.
- Document and maintain system specifications, programming checklists, and operational support documentation.
- Proactively engage with operational leaders, customers, and vendors to drive business-focused technology solutions and ensure a high level of service.
- Provide timely communication to management regarding critical system issues, policy decisions, and application constraints.
Position Qualifications:
Competencies
- Proficiency in COBOL programming and SQL development, including embedded SQL in a DB2 database environment.
- Hands-on experience with Unix AIX platforms and Unix shell scripting.
- Comprehensive understanding of healthcare payer operations including claims, provider, and member management.
- Familiarity with healthcare EDI standards (e.g., 834, 837, 278) and transaction processing.
- Experience coordinating system enhancements, managing system interfaces, and troubleshooting operational data issues.
- Knowledge of software development and change management practices, particularly in healthcare environments.
- Experience with SQL Server, Visual Studio, and Azure platforms is a plus.
- A thirst for learning and the ability to quickly master new technologies.
- Innovative problem-solving mindset, with a drive to modernize and improve systems.
- A collaborative leader who takes ownership and influences across teams.
- A strategic thinker eager to be a key stakeholder in IT initiatives.
- Ability to proactively engage customers and vendors to enhance satisfaction and system reliability
Experience
- Must reside in California.
- Bachelor's degree in Computer Science or related field, or equivalent experience.
- Minimum of three (3) years of programming experience, including system design and analysis, preferably in healthcare or payer operations.
Physical Requirements
- Must be able to sit in a chair for extended periods of time
- Must be able to speak so that you are able to accurately express ideas by means of the spoken word
- Must be able to hear, understand, and/or distinguish speech and/or other sounds in person, via telephone/cellular phone, and/or electronic devices
- Must have ample dexterity which allows entering of text and/or data into a computer or other electronic device by means of a keyboard and/or mouse
- Must be able to clearly use sight so that you are able to detect, determine, perceive, identify, recognize, judge, observe, inspect, estimate, and/or assess data or other information types
- Must be able to fluently communicate both verbally and in writing using the English language
- Must be able to engage in continuous social interaction, successfully manage stressful high conflict situations, and balance multiple duties, expectations and responsibilities simultaneously
Other Information
- Expected Hours of Work: Friday 8am – 5 pm PST; with ability to adjust to Client schedules as needed
- Travel: May be required, as needed by Client
- Direct Reports: None
- Salary Range: $75,000 - $120,000
EEO Statement
It is Clearlink Partners’ policy to provide equal employment opportunity to all employees and applicants without regard to race, sex, sexual orientation, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit-based factor in accordance with all applicable laws, directives and regulations of Federal, state and city entities. This salary range reflects the minimum and maximum target wage for new hires of this position across all US locations. Individual pay will be influenced by Experience, Education, Specialized Soft Skills, and/or Geographic location.