Lead Software Engineer Healthcare Payer SME — CapAdmin Platform at Alivi
Miami, FL
—
Jul 13, 2026
Miami, FL
Jul 21, 2026
What this job asks for AI summary
A hybrid engineering and subject-matter-expert role on a proprietary claims administration platform serving third-party administrator operations. The position centers on translating complex payer workflows — claims adjudication, capitation, COB, UM, and EDI transactions — into complete technical specifications, while also contributing to architecture, code reviews, and mentoring. It suits a senior software engineer with deep, hands-on experience inside a payer or TPA system who can operate equally well with engineering teams and business stakeholders.
Senior level · 8+ years · Miami-Fort Lauderdale-Pompano Beach, FL · Full-time
“or” means any one of them counts — you don't need all of them.
We read this from the posting text with AI. Skim the description below before ruling yourself out.
How this req sits in the market our data
Most people in this occupation already list these. Still required — just not what gets you shortlisted.
What the occupation pays Median $135,567 (middle half $104,969–$169,354).
Estimated from BLS employment for this occupation and area, per-skill prevalence across our listing corpus, and published wage benchmarks — as of Jul 28, 2026. It is a model, not a headcount.
Why we read it this way (9)
The role title is 'Lead Software Engineer' but the posting frames it as a hybrid technical-SME leadership role — roughly equal weight is given to healthcare payer domain expertise and hands-on engineering. The alt SOC 15-1211 (Computer Systems Analysts) is a genuine runner-up given the heavy requirements-translation and SME-guidance responsibilities.
The 7+ years of payer/TPA domain experience and 8+ years of software engineering experience are stated as separate gates; the overall years minimum is set to 8 (the higher engineering floor) as the role-level requirement.
The payer platform experience requirement (section 4.1) is explicitly labeled 'Non-Negotiable' and lists example platforms (Facets, QNXT, HealthRules, HealthEdge, TriZetto, EZ-CAP) as illustrative alternatives — the gate is on payer/TPA platform experience, not any specific named product.
UB04/CMS-1500 processing, COB, Utilization Management, capitation models, and EDI transactions are all listed under the 'Non-Negotiable' requirements section and are treated as hard gates, even though they are domain-knowledge requirements rather than named software tools.
AWS (Redshift/QuickSight stack) is explicitly called 'a strong plus' in section 4.2, so it is marked preferred. HITRUST, HIPAA, and HITECH appear only under Preferred Qualifications (section 5).
Bilingual English/Spanish is listed as a plus given the Miami-based team — not a hard gate.
No compensation range is stated in the posting.
The role is described as hybrid (not fully remote); the team is Miami-based.
Ignored 2 non-technology phrase(s) as skills (responsibilities/concepts, not named tools): CMS-1500 claim processing, Utilization Management.
Read the full posting
The employer publishes the full description on their own site — read it there ↗. Or sign in to read it here — it's free, and it also lets you track this application.