Responsibilities: Base Pay Range: $75,100 - $107,300 plus bonus
The posted range is the hiring range for this role — a subset of the broader range available to employees over time — and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.
For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
In this role, the Manager will
- Analyze client claim processing systems to ensure accurate data mapping, integration, and processing.
- Own end-to-end analysis, testing, and documentation of business requirements, particularly for fields and logic requiring custom programming.
- Interpret and document complex claim scenarios, including adjustments, readmissions, and replacement claims.
- Maintain functional expertise in one or more claims platforms such as QNXT, Health Rules (HRP), TOPS, COSMOS, Facets, Amisys Advance, NASCO, or WGS.
- Design, build, and optimize ETL/ELT pipelines to support large-scale healthcare data processing (e.g., EMR, claims, lab data).
- Perform data cleansing, transformation, and validation to ensure accuracy, consistency, and usability.
- Monitor and troubleshoot ETL workflows to identify and resolve data quality and processing issues.
- Ensure timely and accurate execution of data loads based on predefined schedules for each client.
- Develop, maintain, and document ETL processes, including data lineage, transformation rules, and technical specifications.
- Participate in the design and implementation of data warehouse solutions.
- Collaborate with business stakeholders to gather requirements and translate them into technical solutions.
- Enforce data security, governance, and compliance standards, including adherence to HIPAA and healthcare regulations.
- Ensure strict alignment with documented procedures and guidelines for data loading, layout changes, and system updates.
- Perform layout modifications and mapping adjustments based on client or system requirements.
- Conduct thorough quality checks to validate loaded data and resolve inconsistencies.
- Stay updated on evolving technologies and best practices in ETL, data warehousing, and healthcare data management.
