Remote Healthcare EDI Systems Analyst

Join a dynamic team that values expertise in Health Insurance EDI and the ability to design and implement EDI solutions for customers for a remote position as an EDI Solutions Architect. If you have a deep understanding of EDI and Data Exchange analysis and workflow design, specifically within the healthcare industry and EDI Transactions 837, 835, 834, 278, then you may be a great fit for this role. Our client is looking for someone with hands-on experience working with or directly for a Health Plan Commercial Payer.

The ideal candidate will possess the skills and expertise of a Systems Analyst with an Implementation focus. A strong technical background, particularly in designing EDI solutions and with customer implementations is key to this role.

Candidates should have a solid understanding of EDI transaction sets, specifically 834, 835, and 837, with familiarity with 278 being a significant advantage. This position is best suited for individuals who thrive in an implementation and support role and have a deep knowledge of healthcare-related EDI processes.

As a self-starter with a passion for Health Care EDI and for helping customers achieve their integration objectives, you will excel in this role. You have a track record of taking ownership, working under tight timelines, and handling multiple tasks with ease, all while maintaining a positive work culture. Bring your expertise in Health Insurance EDI and your knack for customer-focused solutions to our client's team and take your career to the next level.

In this role, you will create implementation strategies to align with and achieve stakeholder goals. You will work closely with Healthcare Payers and Networks to understand their operational and technical integration requirements. You will define Healthcare EDI-related requirements for payer-to-network integrations, and eventually for building integrations on the company's platform. As a subject matter expert for enterprise healthcare EDI technology, you will support and educate team members across the organization. You will build and continuously optimize implementation processes and procedures, demonstrating teamwork and contributing to a positive work culture.

The Client is looking at candidates interested in a Contract-to-hire or an FTE position.

Responsibilities:

Creates implementation strategies to align with and achieve stakeholder goals

Collaborates with internal and external stakeholders to deliver integration objectives;

Defines and implements implementation strategies consistent with stakeholder goals;

Provides subject matter expertise to EDI Solution Architects as they design and build integration solutions

Works closely with Healthcare Payers and Networks to understand integration requirements

Works closely with Healthcare Payers and Networks to understand their operational and technical integration requirements in order to define requirements and design integration solutions.

Creates documentation and processes to ensure delivery of high quality integrations

Creates data exchange specifications and requirements to support healthcare data integrations;

Works closely with engineers to provide clear requirements for building customer integrations

Produces documentation to achieve high quality integrations;

Builds and tests customer integrations and documentation;

Assists with internal testing and works closely with customers during UAT phase of implementation projects.

Reviews implementation integration solutions for completeness and fulfilment of all requirements

Acts as a SME for EDI and Industry Knowledge

As a SME, provides EDI and industry knowledge-sharing across all of the Company's teams;

Maintains a deep understanding of the Company's platform product capabilities;

Work closely with Product Management to provide input and feedback on platform features and functionality to support building customer integrations;

Participates actively in Scrum related activities, including sprint planning and grooming.

Builds and continuously optimizes implementation processes and procedures

Proactively works to identify new features required to optimize integrations;

Builds and continuously optimizes implementation processes and procedures.

Demonstrates team-work and contributes to a positive work culture

Recognized as a leader in area of specialty;

Collaborates with team to achieve organizational goals;

Contributes to development of a positive work culture by demonstrating teamwork and alignment with core company values;

Constructively escalates problems and issues;

Actively collaborates with other departments and teams.

Qualifications:

7+ years' experience as a software Systems Analyst or Business Analyst, gathering/documenting business requirements and translating into technical specifications.

7+ years' experience working in a US Health Plan Commercial Payer environment.

5+ years' experience in an external, client facing role

Expert understanding of HIPAA transaction sets 837, 834, 835, 278 required.

Hands-on experience with HIPAA logical mapping and system implementation required.

Experience analyzing, designing, and maintaining Business process Workflows.

Experience with Troubleshooting and resolving EDI and other Data issues in a production environment

General knowledge of healthcare operations, payer business processes and provider and EDI infrastructures.

Experience with building cloud services or SaaS technologies. Strong knowledge of and aptitude for cloud computing principles.

Ability to develop strong working relationship with engineering and stakeholder groups, and the curiosity and skill to dig deeper into requirements and the "why " with limited guidance.

BS in Computer Science/Information Systems or equivalent experience.

Excellent oral, written documentation, and presentation abilities.

Your Background May Additionally Include:

MS in Computer Science/Information Systems

Claims, enrollment, and pricing configuration experience

EDI QA experience

Salary Range: The target salary for this position is in the range of $115,000 to $140,000 annually. The actual salary offered to the selected candidate will be determined by the hiring company and is contingent upon the candidate's qualifications, relevant experience, and skills. Our Client is committed to pay equity and strives to offer competitive compensation packages that align with industry standards and the candidate's unique background.