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.
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 maintain 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. You will provide subject matter expertise and assist with providing mentoring and training.
ABOUT THE TEAM
The Electronic Data Interchange (EDI) Unit manages relationships with trading partners, ensures implementation of new EDI transactions, oversees encounter data quality, and ensures data exchange transactions adhere to regulatory requirements.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- 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
- Healthcare industry and the principles of healthcare planning
- Ability to:
- Manage multiples project 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 multiples 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
- 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
- While this position is connected to one of our Alliance offices, we are in a fully telecommute work environment right now due to the COVID-19 pandemic. The interview and on-boarding process for this position will be completed remotely
- This position may require onsite presence when our offices re-open, which will be no sooner than February 1, 2022. Onsite presence will most likely be on a part-time basis, but is dependent on business needs
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 377,000 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 any type of employer supported or provided sponsorship.