Full-Time
Lead Software Engineer
Healthcare Payer
Updated on 8/21/2026
Alivi
51-200 employees
Tech-enabled benefit manager integrating medical benefits.
No salary listed
Miami, FL, USA
Hybrid
Hybrid work is required.
 Software Engineering (1) |
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- At least 6 years of experience working inside a payer platform, Third-Party Administrator system, or claims administration software.
- Hands-on experience with UB04 and CMS-1500 claim processing.
- Experience with Coordination of Benefits rules and logic, including NAIC order of benefits and Medicare secondary payer.
- Experience with Utilization Management workflows.
- Experience with capitation models and reconciliation.
- Experience with Electronic Data Interchange transactions, including 837, 835, 834, 270/271, and 278.
- Working knowledge of CPT, HCPCS, ICD-10, revenue codes, and place-of-service codes.
- Familiarity with CMS, state Medicaid, and commercial payer requirements.
- At least 6 years of professional software engineering experience.
- Strong proficiency in C#, .NET, Java, or similar enterprise languages.
- Experience with relational databases such as SQL Server or PostgreSQL and data modeling for claims and payer systems.
- Experience with REST APIs, microservices, and integration patterns.
- Comfort with Agile/Scrum, continuous integration and continuous delivery, and modern DevOps practices.
- Ability to mentor engineers and translate domain knowledge across technical and business audiences.
- Ability to participate in customer- and executive-level conversations.
- Bilingual English and Spanish proficiency, with Spanish required.
- Serve as the internal subject-matter expert for payer and Third-Party Administrator workflows, including institutional and professional claim form processing, Coordination of Benefits, Utilization Management, capitation, eligibility and enrollment, claims adjudication, and Electronic Data Interchange standards.
- Translate complex payer business requirements into complete technical specifications before development begins.
- Partner with Operations, Finance, and Compliance to validate claims and capitation logic end to end.
- Partner with the CapAdmin Development Lead to drive architecture, scalability, and platform modernization.
- Lead code reviews with a healthcare payer domain focus and identify business logic errors.
- Mentor mid-level developers on healthcare payer concepts.
- Contribute to the design and implementation of new product-line integrations, including Ophthalmology and expanded Coordination of Benefits.
- Own requirements completeness by ensuring every feature has full payer-domain context before sprint commitment.
- Work with Business Analysts, Quality Assurance, and Product to address incomplete requirements and reduce CapAdmin defects.
- Define and document acceptance criteria grounded in payer regulations and customer contracts.
- Partner with Operations leadership on claims accuracy, capitation reconciliation, and customer-facing escalations.
- Support customer-facing technical conversations with payer clients when domain expertise is needed.
- Collaborate with Architecture, Security, and Data/Business Intelligence teams on enterprise alignment.
- Familiarity with Amazon Web Services, including the Redshift, AWS, and QuickSight stack.
- Prior experience at a Third-Party Administrator, Managed Services Organization, Independent Practice Association, or health plan in a technical leadership role.
- Experience with specialty benefits administration, including vision, transportation, podiatry, and therapy.
- Familiarity with HITRUST, HIPAA, and HITECH compliance requirements for payer systems.
- Experience supporting Medicaid managed care, including Sunshine Health, Humana, or Florida Medicaid.
- Background in risk-based contracts, sub-capitation, and value-based care arrangements.
Alivi Health coordinates both clinical and non-clinical benefits through a tech-enabled delegated benefits manager for provider networks, including Non-Emergency Medical Transportation (NEMT). Its platform integrates NEMT with medical benefits and applies a care coordinator model to Medicaid and Medicare populations, enabling end-to-end utilization management for services like Physical Therapy, Occupational Therapy, Speech Therapy, ABA, Vision, and more. This clinically integrated approach helps remove barriers to care and improve adherence by proactively guiding members through the care path. Alivi differentiates itself by being the only healthcare company with a developed NEMT benefit management solution and by combining clinical and non-clinical benefits within a single coordinated program. Its goal is to close care gaps and ensure members receive timely, appropriate care through coordinated networks and utilization management.
Company Size
51-200
Company Stage
N/A
Total Funding
N/A
Headquarters
Miami, Florida
Founded
2012
Get referred to Alivi
See people who can refer or advise you
Simplify's Take
What believers are saying
- January 2025 Weinbach said two contracts will double revenue and headcount.
- LinkedIn reported 400 new jobs since early 2025, showing continued expansion.
- March 2025 Podimetrics partnership broadens specialty benefits and deepens payor relationships.
What critics are saying
- Revenue concentration in Florida Medicaid and Medicare contracts creates renewal dependence by 2027.
- BBB logged three complaints in three years, signaling provider and member friction.
- If Sunshine Health or CarePlus switches brokers, Alivi loses core volume and hiring momentum.
What makes Alivi unique
- Alivi bundles NEMT, vision, podiatry, and therapy into one delegated platform.
- March 2025 Bambi integration automates scheduling, dispatch, and billing for providers.
- January 30, 2026 CarePlus awarded Alivi its optometry benefit, validating specialization.
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Benefits
Health Insurance
Dental Insurance
Vision Insurance
Health Savings Account/Flexible Spending Account
Life Insurance
Paid Vacation
Employee Referral Bonus
Company News
Alivi Health: NEMT broker guide for transportation providers |. 04/09/2026 Last updated: 04/09/2026 5 mins read Rate this post Since 2016, Alivi Health has helped low-income individuals and families access key medical health services. It has built a network of non-emergency medical transportation (NEMT) providers with a record-low rate of missed trips. This is in large part due to its increased adoption of advanced integrated technology. But beyond that, the organization also claims to have lowered the complaints of many of its members by up to 20%. For NEMT providers, it offers a chance to be a part of a diverse team of passionate individuals devoted to providing better quality care. Contents: About Alivi. Miami, Florida-based Alivi Health has been an NEMT broker since 2016. The firm also provides a comprehensive suite that includes support for vision, dental, and chiropractic services, along with aid for various therapies. Over the last few years, the organization has grown in prominence. In 2024, Alivi Health doubled its workforce after landing two Florida Medicare contracts. Its CEO, Magdiel Rodriguez, was a finalist in Ernst & Young's 2024 Entrepreneur of the Year shortlist. The advanced benefits-integrated platform aims to improve the quality of care for its members, payors, and providers. For NEMT providers, the goal is to provide eligible and effective transportation while reducing costs for its members and healthcare payors. Alivi integrates with RouteGenie's software for scheduling, billing, routing, and dispatching processes, a partnership that helps medical transportation providers deliver a more reliable service. Where does Alivi operate? Alivi is based in Miami, Florida, but operates in at least 18 states in total. Until 2023, it actively provided services in 13 states, including Florida, Ohio, and Arizona. Since then, it's added another five to the list: * New Jersey * New York * Pennsylvania * Massachusetts * Alabama These are the latest additions by the organization, but it is a list that's likely to see more revisions. Alivi had been named in Inc.'s list of the 5,000 fastest-growing companies in the US for six consecutive years, 2019-2024. In 2025, they made it to the Inc. Regionals 2025: Southeast list, so further expansion is clearly on the horizon. "We remain focused on delivering exceptional value to our clients and partners as we continue to expand and advance our mission," CEO Rodriguez said. How to become an Alivi NEMT provider. To join Alivi Health's membership program, visit the Alivi Health website and navigate to the "Join Alivi Network" tab. To apply as an Alivi NEMT provider, you have the option to complete the callback form via these links as a transportation provider or a specialty provider. Once you select the correct option, you'll be prompted to fill in a contact form with basic details. You'll need to provide your company name, phone number, email, and the states and counties where you operate. A member of the team will contact you in two business days with more information. After approval, providers attend a training session and sign a contract with Alivi before receiving trips. Credentialing is managed through Alivi's provider portal, where you upload and maintain all required documents. CAQH numbers, if available, speed up the process. Credentialing is completed once and covers participation across all Alivi plans. On this page, meanwhile, you will find multiple videos helping you through the onboarding process for the AliviRide app. Why work with Alivi and what do they offer providers? Alivi Health focuses on enhancing its member experience in multiple ways. Its platform helps health plans and state agencies reduce costs, improve the quality of care, and address social determinants of health. Here is how it helps members gain a competitive edge: * Personalized assistance to address challenges and grow your business * Streamlined claims processing through the transportation provider platform * Easy dispatch and management for members and transportation providers * Advanced auto-assignment technology tailored to your custom profile * Integration with key technology systems to reduce expenses. Alivi pays out claims weekly at a 98% clean claim rate, one of the better payment turnarounds in the NEMT broker market. Providers are assigned a dedicated Provider Relations Representative from day one, with Alivi's Ride Assist team available for additional support across a range of on-trip situations. The auto-assignment technology is built around each provider's custom profile, and Alivi's dispatching platform is designed to manage trips with minimal manual input. Providers choose which health plans to participate in and can opt out or terminate at any time. There's no lock-in. In 2023, Alivi Health claimed it had achieved 90% digitization for its NEMT solution. It also stated it had a 99.89% clean claim rate, both of which are promising for providers. How RouteGenie supports Alivi's mission. RouteGenie is an advanced NEMT broker integration software that allows providers to synchronize their trip data with brokers like Alivi Health. The system helps automate the flow of important information related to trip details or payment, improving the overall quality of the trip. Request a RouteGenie Demo to see how it works in action. Rate this post Serhii Taborovskyi Serhii Taborovskyi is the founder and author of the Automotive Territory YouTube Channel, with 300,000 subscribers and counting. He is an avid automotive enthusiast and a fan of any and all motorized vehicles. Serhii is a visiting author at RouteGenie, sharing his expertise for the benefit of the NEMT community.
The Weinbach Group Will Spearhead PR And Marketing For The Rapidly Growing Healthcare Benefits CompanyMIAMI, Jan. 14, 2025 /PRNewswire/ -- The Weinbach Group, a leading healthcare marketing firm, announced that Miami-based Alivi Health, a healthcare benefits company, engaged the Miami public relations firm to assist with corporate communications. Alivi coordinates non-emergency medical transportation as well as clinical benefits for managed care organizations throughout Florida and in other states. Alivi hired The Weinbach Group to help the company elevate its marketing and communications program in the context of its rapid growth and expansion.Alivi recently signed two landmark agreements that will double the company's revenue and headcount and will add more than 1.5 million members to the population for which it provides transportation services. The Weinbach Group will handle Alivi's public relations and publicity activities. In addition, the veteran healthcare advertising agency will develop and execute an integrated marketing program to leverage Alivi's growth and support the company's expansion into new markets throughout the U.S."At its core, Alivi Health is a company committed to improving healthcare access to underserved populations, often by providing life-saving transportation," said Daniel Weinbach, president and CEO of the Miami ad agency
This is a watershed moment in our company's history, and it's also a tremendous opportunity to make a positive impact on the lives of millions of Floridians
Alivi Health has once again made it onto the Inc. 5000 annual list, marking the sixth consecutive year the company has achieved this accomplishment.
MIAMI--(BUSINESS WIRE)--Alivi Health, a leading provider of specialty benefits, is pleased to announce the appointment of Shea Long as Chief Product Officer (CPO). Long's exceptional track record in healthcare innovation, product management, and go-to-market strategies makes him the perfect fit for this position. As a growth leader, he specializes in scaling high-growth businesses within the healthcare and technology sectors. Before joining Alivi Health, Long served as the Head of Commercial Innovation at Centene, where he spearheaded the implementation of technology-based solutions to enhance health outcomes, optimize resource utilization, and improve customer satisfaction metrics. His professional journey began in the technology industry, holding senior product leadership roles at ATT Wireless, Lumen Technologies, and Unisys. Long has also held key leadership positions in prominent companies such as Papa, EmpowerMe Wellness, and ModivCare, where he successfully implemented product and go-to-market strategies, resulting in significant growth and market expansion