We have an opportunity to join the Alliance as an EDI Analyst III in the Application Services Department. This is a remote opportunity within California, in order to qualify for this role, you must currently reside in the state of California or plan to reside in the state of California at the time of starting this role. Relocation assistance is not included.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the EDI Manager, you will lead the implementation of new EDI transactions, x12 and proprietary, including data analysis, requirements assessment and gathering, and solution design and testing. You will perform deep dive analysis and maintains the accuracy of production healthcare EDI transactions and processes, including encounter data oversight. You will manage relationships with trading partners, such as providers, vendors, and regulatory agencies and provide subject matter expertise and assists with providing mentoring and training.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- All HIPAA EDI protocols
- ANSI X12 healthcare transactions including but not limited to 837 I/P, 834, 835, 270/271, 274, 276/277 files
- Current technology transmissions and receipt methods and the requirements of electronic data submissions
- Software product lifecycle management, from defining requirements to implementation
- Systems development lifecycle
- Formal testing methodology, the principles and practices of test plan development and execution, and documentation of test results
- Advanced SQL
- Ability to:
- Manage multiple projects simultaneously, organize work, maintain accurate records, respond to changing priorities, and achieve goals and timelines
- Work collaboratively with individuals at all levels in a matrix organization while supporting multiple stakeholders
- Define issues, collect and interpret complex data, develop solutions, project consequences of recommendations, and prepare written reports
- Perform technical and non-technical troubleshooting and diagnose and resolve problems efficiently and effectively
- Develop and translate business requirements and apply rules, regulations, policies, procedures and guides
- Demonstrate flexibility and creativity, identify improvements to existing practices, and effectively adapt to change
- Train, guide and act as an EDI resource to staff and trading partners
- Work independently with minimal supervision and as a member of a team
- Education and Experience:
- Bachelor's degree in Information Technology, Computer Science, Computer Engineering, Healthcare or a related field
- Minimum of five years of business analysis experience in a Medi-Cal or managed care environment (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
- Medical, Dental and Vision Plans
- Ample Paid Time Off
- 11 Paid Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- EV Charging Stations
- And many more
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve over 330,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here.
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for sponsorship.