Senior Healthcare Application Support Engineer – Prior Authorization

V2Soft is a global leader in IT services and business solutions, delivering innovative and cost-effective technology solutions worldwide since 1998. We have headquartered in Bloomfield Hills, MI and have 16 offices spread across six countries. We partner with Fortune 500 companies to address complex business challenges. Our services span AI, IT staffing, cloud computing, engineering, mobility, testing, and more. Certified with CMMI Level 3 and ISO standards, V2Soft is committed to quality and security. Beyond our work, we actively support local communities and non-profits, reflecting our core values. Join us to be part of a dynamic and impactful global company!

Senior Healthcare Application Support Engineer – Prior Authorization

Job Description

V2Soft is seeking a Senior Healthcare Application Support Engineer to support production clinical and provider-facing applications within a healthcare payer environment. The ideal candidate will have strong experience in healthcare application support, prior authorization, SQL, Java/web services, and EDI X12 transactions.

Experience with Cognizant CareAdvance and CareAdvance Provider is highly preferred and will be a key differentiator.

Key Responsibilities

• Triage, diagnose, and resolve production incidents across clinical and provider-facing healthcare applications while meeting defined response and resolution targets.
• Manage a high-volume inbound support queue by accurately classifying, troubleshooting, resolving, or routing requests.
• Investigate prior authorization exceptions, tracing transactions from the inbound request through the application and underlying data.
• Analyze application behavior, database records, transaction data, and application/server logs to identify the root cause of production issues.
• Determine whether an issue originates within in-house applications or a third-party/vendor product and provide supporting evidence for vendor escalation.
• Troubleshoot application integrations and web services, including SOAP and REST APIs.
• Use SQL to independently investigate production issues and validate application data.
• Analyze EDI X12 278 prior authorization request and response transactions, including raw segment-level content.
• Document incident resolution, root cause analysis, troubleshooting procedures, and solutions in knowledge base articles.
• Work within an ITSM environment and adhere to severity-based response and resolution SLAs.
• Participate in an on-call rotation as required.

Required Qualifications

• 5–8 years of experience in application/production support.
• 3+ years of experience supporting healthcare payer systems.
• Strong hands-on SQL experience with Oracle and SQL Server.
• Ability to read and troubleshoot Java application code.
• Experience interpreting application server and production logs.
• Hands-on experience testing and troubleshooting SOAP and REST web services using tools such as SOAP UI or Postman.
• Strong understanding of EDI X12 278 transactions for prior authorization requests and responses, including the ability to read raw segment content.
• Experience with an ITSM platform such as Ivanti Neurons, Cherwell, ServiceNow, or an equivalent tool.
• Strong production troubleshooting, incident management, root cause analysis, and problem-solving skills.
• Ability to work on-site at the V2Soft office in Michigan.

Preferred Qualifications

• Hands-on experience with Cognizant CareAdvance.
• Experience supporting or configuring CareAdvance Provider for provider-facing prior authorization workflows.
• Experience with other healthcare Care Management / Utilization Management platforms, including:
• TriZetto Facets
• TriZetto QNXT
• HealthEdge GuidingCare
• ZeOmega Jiva
• Altruista
• Other commercial or proprietary UM/CM platforms
• Experience with healthcare clearinghouse integrations.
• Familiarity with FHIR and healthcare interoperability.
• Awareness of CMS interoperability requirements.
• Experience with additional EDI transactions such as 834, 837, and 835.

V2Soft is an Equal Opportunity Employer ( EOE). We welcome applicants from all backgrounds, including individuals with disabilities and veterans.

https://www.v2soft.com/careers - to view all of our open opportunities and to learn more about our benefits.