Software Engineer, Core Systems

Software Engineer, Core Systems

Direct Hire Full-Time Role

Salary Range: $93,600 - $114,400 per year

Location: South San Francisco, CA - Hybrid Role

Job Summary:

As a skilled Software Engineer, you will maximize the use and performance of core systems through tailored programming and system enhancements. This hands-on role requires strong expertise with Unix AIX platforms, embedded SQL, COBOL, Unix shell scripting, and DB2 databases. Familiarity with healthcare payer operations is highly recommended, particularly with Claims, Provider, and Member datasets, along with exposure to EDI transactions and their underlying standards. You will collaborate with system users and technical teams to design solutions that address complex business needs, contributing to efficient and reliable healthcare service delivery. This position may require occasional after-hours availability to address urgent system matters.

Duties and Responsibilities:

• Develop, maintain, and monitor core system data processing and data interfaces such as encounters/claims, membership, authorization, and provider configurations to ensure timeliness and accuracy.


• Design and code new programs, modify existing ones, and create detailed programming specifications according to business user requirements.


• Coordinate and manage Program Change Requests with both internal users and external vendors.


• Document and troubleshoot errors and bugs within the claims/eligibility systems and other in-house software.


• Establish and refine standardized testing processes and best practices.


• Conduct testing for new software releases and manage their implementation, ensuring thorough documentation is maintained.


• Create and update system and program documentation and checklists.


• Oversee vendor relationships to support daily operational needs effectively.


• Proactively engage with customers to enhance satisfaction with the services and processes supported.


• Translate user needs to program functional specifications, communicating with users to gather the necessary details to complete tasks/projects.


• Inform management about critical system issues, policy decisions, and application constraints.


• Provide round-the-clock availability to address and resolve urgent system issues.


• This position may require occasional after-hours availability to address urgent system matters.


• Learn new techniques, systems, and languages.


• Produce ad hoc reports.


• Perform other duties as assigned.

Requirements and Qualifications:

• Bachelor's degree in computer science or related field


• 3 years of programming experience, including system design and analysis, preferably software change management and/or development experience.


• Understanding of general healthcare processes such as Claims, Membership, and Provider management


• Experience with software development on Unix AIX platforms and DB2 databases.


• Familiarity with AIX environments, including system navigation, scripting, and deployment processes


• Proficiency in COBOL, with a proven ability to develop, maintain, and optimize legacy systems.


• Hands-on experience with embedded SQL for database integration, query optimization, and reporting tools


• Experience with SQL Server, Visual Studio, and Azure.


• Proficient in SQL programming and Unix shell scripting.


• Comprehensive knowledge of systems and related system interfaces, along with the ability to assess the impact of changes across various systems


• Intermediate experience with one or more EDI transactions, including standards such as 834, 837, and 278


• Working knowledge of healthcare payer operations and data security standards is a plus.


• A background in the healthcare sector and managed care is highly preferred, as familiarity with healthcare processes and regulations will be highly advantageous.


• Able to quickly develop a working knowledge of our core systems.


• Adaptable to changes in requirements/priorities for daily and specialized tasks


• Able to multitask and meet deadlines.


• Can communicate effectively and provide a high standard of customer service.

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