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Principal, Health Plan Integrations

Remote

Radiology is the second most used healthcare service, used by over 51% of the workforce annually. Despite the critical role of radiology in healthcare, the process for undergoing a medical imaging exam has remained unchanged for decades. OneImaging is solving this with a concierge approach and a premium-quality radiology network of over 4,000 vetted providers across 48 states, which also reduces imaging costs by 60-80%. Our solution helps patients and families access essential radiology services at fair prices and without surprise bills, all while delivering immediate savings and ROI for employers and payers on every exam.

We are seeking a detail-oriented, proactive, and highly organized Principal, Health Plan Integration to support the successful onboarding and integration of new customers and ecosystem partners, including health plans, third-party administrators (TPAs), and utilization management vendors.

This role is critical to ensuring a seamless go-live experience for customers by navigating complex health plan relationships, managing data and operational workflows, and coordinating with both internal and external stakeholders. You will serve as a subject matter expert on health plan requirements and integration best practices to the Implementation Manager and lead. This position reports directly to the SVP of Customer Success and Partner Operations.

What you'll do:

Health Plan Operations Expertise

  • Act as a subject matter expert on end-to-end health plan operations, understanding cross-departmental workflows and their direct impact on provider and vendor partners

Systems & Vendor Integrations

  • Lead integrations between health plan core systems (claims, enrollment, care management) and OneImaging.
  • Assist in defining integration requirements for:
    • File-based exchanges (834, 835, 837, custom flat files)
    • APIs and real-time integrations
  • Ensure data accuracy, timeliness, reconciliation, and downstream usability.

Configuration & Implementation

  • Partner with Health Plan Partners and internal stakeholders to-
    • Configure eligibility, benefits, claims rules, and medical management logic
    • Translate medical policy and benefit intent into executable system rules
  • Validate configurations through testing, UAT, and production readiness.

About you:

Technical & Integration Knowledge

  • Strong understanding of:
    • EDI (834, 835, 837, 270,271)
    • Healthcare data flows and reconciliation
    • Core health plan systems (e.g., Facets, QNXT, HealthEdge, Epic Tapestry, Amisys, etc.)
  • Comfortable translating business and clinical requirements into technical integration specs.

Experience

  • 8–10+ years of experience in health plan operations, healthcare IT, or healthcare implementations that involved health plan integration
  • Direct, hands-on experience with a deep understanding of how these departments connect with the member and provider experience within a health plan
    • Eligibility & enrollment processing
    • Claims configuration and adjudication
    • Claims billing
    • Medical management systems
    • Vendor implementations and ongoing operations

The target base salary range for this position is $150,000 - $190,000.  Individual compensation will depend on various factors, including qualifications, skills, experience, location, and applicable laws. In addition to base salary, this role is eligible to participate in our equity incentive and competitive benefits plans. 

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Equal Employment Opportunity:

OneImaging is proud to be an Equal Employment Opportunity employer and values diversity in the workplace. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views, or other applicable legally protected characteristics.

OneImaging is committed to providing accommodations for qualified individuals with disabilities in our recruiting process. If you need assistance or an accommodation due to a disability, you may contact us at talent@oneimaging.com. 

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