Who We Are
Proactive Logic Consulting INC is a boutique technology consulting firm specializing in:
- Innovation, zero to one projects
- Process Automation and AI
- App Modernization (including Low-Code solutions)
- Assessments & Roadmaps
- Azure Cloud Migrations
We bring together top-tier independent consultants—experts in their craft who thrive on flexibility and autonomy. Our consultants have a strong customer-obsessed mindset, high EQ, and deep technical skills. We're entrepreneurial at heart and fully support individuals who are simultaneously building their own product ventures.
What We're Looking For
We need an experienced Senior Healthcare Integration Consultant with deep knowledge of EDI 834 transactions and eligibility/enrollment workflows. You'll lead the re-engineering of a healthcare client's vendor data integration stack—replacing manual-intensive processes with an automated, monitored platform. This role is corp-to-corp, 1099.
We don't care what language you've written most of your code in. If you know 834 inside and out, understand healthcare enrollment operations, and you're AI-forward in how you build—we want to talk. Our stack is Azure/.NET, but the right domain expert with strong AI engineering practices will ramp fast.
What You'll Do
- Re-engineer Integration Pipelines: Design and build an automated platform for inbound/outbound vendor data feeds—replacing legacy manual processes with modern, monitored pipelines.
- EDI 834 Processing: Implement 834 file ingestion, parsing, transformation, and mapping—including support for non-standard codes, custom configurations, and exception handling.
- Reconciliation Framework: Build SOX-style reconciliation with record-level validation, count verification, and payload error detection across all vendor feeds.
- Eligibility Workflows: Build transaction processing pipelines handling employer portal submissions, email-based requests, CRM-driven tasks, and batch queue processing.
- Monitoring & Alerting: Implement real-time pipeline visibility with configurable thresholds for late files, failures, reconciliation mismatches, and volume anomalies.
- Business Process Automation: Partner with ~15 SMEs to map current-state workflows, document decision trees, and automate repetitive manual eligibility edits.
- Quality & Compliance: Ensure HIPAA compliance, PHI handling best practices, and full audit trail from source file through transformation to target system.
Key Requirements
Healthcare Integration Domain Expertise (Required)
- 5+ years working with healthcare enrollment, eligibility, or benefits administration systems.
- Hands-on experience with EDI 834 (Benefit Enrollment and Maintenance)—file formats, transaction sets, and common implementation variations.
- Understanding of enrollment operations: adds, terms, changes, reinstatements, COBRA, and eligibility lifecycle events.
- Familiarity with HIPAA transaction standards and PHI handling requirements.
Integration Engineering (Required)
- 10+ years building data integration pipelines—batch, file-based, streaming, or event-driven.
- Strong experience with file ingestion patterns: SFTP, flat file parsing, EDI parsing, transformation/mapping engines.
- Reconciliation and data quality: validation frameworks, error quarantine, retry logic, audit trails.
- SQL proficiency and experience with relational data stores.
AI-Forward Engineering (Required)
- Daily practitioner with AI coding tools: Claude Code, GitHub Copilot, Cursor, OpenAI Codex CLI, or similar.
- You use AI to accelerate delivery—not as a novelty. We expect you to leverage LLMs for code generation, data mapping, testing, and documentation.
- Experience building or integrating AI-assisted workflows is a strong plus.
Cloud & Platform (Preferred)
- Our stack is Azure/.NET (App Service, Functions, Service Bus, Storage, Key Vault)—experience here is a strong advantage but not a gate.
- Comfortable with CI/CD pipelines and cloud-native deployment patterns.
- If your background is Python, Java, or another stack—that's fine if you bring the domain expertise and AI-forward engineering practices above.
Consulting & EQ
- Excellent client-facing communication; you'll partner directly with enrollment teams, operations staff, and IT leadership.
- High emotional intelligence to navigate team dynamics and client relationships effectively.
- Self-directed and comfortable working with minimal oversight.
Nice to Have
- .NET / C# experience (ASP.NET Core, Web APIs, background services).
- Experience with EdiFabric or similar 834/HIPAA transaction processing libraries.
- SSIS migration experience—modernizing legacy ETL into cloud-native pipelines.
- Power Platform familiarity (Power Apps, Power Automate, Power BI).
- Background in pharmacy benefit management (PBM) or health plan administration.
- Kafka, Databricks, or streaming data platform experience.
Business Structure
- Must have an active LLC or S-Corp to qualify.
- This opportunity is 1099 Only (Corp-to-Corp).
Why Join Proactive Logic Consulting?
- Flexible Engagements: Autonomy in how you work and deliver.
- Top-Tier Peers: Collaborate with senior experts across cloud, data, and AI.
- Impactful Projects: Real business outcomes in healthcare modernization—not maintenance work.
- AI-Forward Culture: Be on the leading edge of agentic software delivery.
- Entrepreneurial Community: Connect with peers building high-impact companies.
How to Apply
If this describes your ideal consulting engagement and you meet the qualifications, please send:
- Your resume or consultant profile highlighting healthcare integration and 834/eligibility experience.
- A brief description of your LLC or S-Corp (name, location).
- A short statement on your healthcare domain experience—specifically your work with 834 transactions and enrollment/eligibility systems.
- A short statement on how you use AI tools (Claude Code, Copilot, etc.) to accelerate delivery while maintaining quality and safety.
Pay: $75.00 - $110.00 per hour
Work Location: Remote
