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Mizzeto —Remote
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Interoperability & Data Integration Consultant

Mizzeto
Remote

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Job Details

Contract

Qualifications

SFTP
Systems integration
Data Integration (Data management)
HL7 interface engines
CMS
Integration Architecture Design (Architecture design skills)
CMS regulatory compliance
Health insurance knowledge
Enterprise Integration
Contracts
FHIR

Full Job Description

Interoperability & Data Integration Consultant

Location: Remote (U.S. Based)
Job Type: Short-Term Consulting Engagement | 1099 Contract

Mizzeto is seeking a consultant with strong knowledge of how clinical data—specifically ADT (Admit-Discharge-Transfer) feeds—flows from hospital EHR systems (Epic, Cerner) to health plans. We need someone who understands the architecture, integration pathways, and the operational and contractual landscape involved in payer-provider data exchange.

WHAT WE NEED EXPERTISE IN:

How ADT feeds move from Epic and Cerner to health plans: HL7v2 (MLLP/SFTP), FHIR Subscriptions, and HIE-mediated approaches
The end-to-end data flow from an ED admission event at a health system to a matched member record at an MCO
Health information exchange (HIE) infrastructure: what state and regional HIEs can and cannot do as intermediaries
Data use agreements, BAAs, and the contracting process required to establish data-sharing relationships with provider organizations
Member-matching logic: how ADT events map to health plan enrollment and eligibility files
Clinical classification of ED visits (NYU Algorithm, Billings, AHRQ PQI) to distinguish emergent from non-emergent utilization
The realities of working across health systems with varying EHR platforms and levels of technical maturity

REQUIREMENTS:

7+ years in healthcare IT, health plan operations, or health information exchange
Strong working knowledge of how ADT feed integrations are established between provider health systems and payer organizations
Payer-side experience: Medicaid MCO, Medicare Advantage, or D-SNP in an interoperability, population health, or care management role
Understanding of HL7v2 ADT messaging, FHIR-based interoperability standards, and HIE infrastructure
Familiarity with the contracting and regulatory landscape for health system data sharing, including CMS Interoperability rule requirements

PREFERRED:

Experience at a Medicaid MCO or national managed care organization
Familiarity with claims platforms (QNXT, Facets) and care management system integration points
Background in ED diversion, avoidable ED, or high-utilizer intervention programs
Knowledge of how different health systems and EHR vendors approach data sharing with payers

Job Type: Contract

Work Location: Remote

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