Jobs at Integra Partners

Supports pricing, sales, and business development analytics by analyzing healthcare claims, reimbursement data, utilization, margins, profitability, and performance metrics. Maintains pricing models, fee schedules, reports, and business pipeline models; researches healthcare coding and payer methodologies; supports proposals, contract modeling, ROI analysis, and scenario planning. Communicates actionable insights to leadership and collaborates with Sales, Finance, Operations, and other stakeholders.

Design, implement, and maintain EDI and integration services for healthcare, handling HL7/X12 (and FHIR) data transformations, containerized deployments, monitoring, testing, load testing, and CI/CD automation using Java/Golang, Edifecs tools, Docker/Kubernetes, and collaborating with SRE and cross-functional teams.

Identify, research, and qualify payer prospects to build pipeline; execute outbound campaigns and support meetings; maintain Salesforce CRM and reporting; analyze campaign and pipeline metrics; support opportunity progression through proposal, contracting, and implementation transition.

Lead payer-focused business development to grow Integra's payer client book. Build pipeline, engage senior health plan decision-makers, close deals, support implementations, forecast revenue, and collaborate cross-functionally. Travel up to 50% for conferences.

Direct and operationalize Utilization Management (UM) for health plan clients: manage clinical and non-clinical teams, maintain UM policies and certifications (NCQA/URAC), oversee prior authorizations and appeals, run quality improvement and audits, configure medical management software, support client engagements and business development, and ensure compliance with legal, regulatory, and contractual requirements.