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Lead EDI Analyst/Developer

Prominence Health Plan Reno Full-Time
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Founded in 1978, Universal Health Services, Inc. (UHS)* is one of the nation’s largest and most respected healthcare management companies, operating through its subsidiaries—acute care hospitals, behavioral health facilities and ambulatory centers nationwide. With more than 74,000 people employed by UHS subsidiaries, UHS’s business strategy is to continue to grow by building or purchasing healthcare facilities across the country, while continuing to strengthen UHS’s well-reputed franchise with its customary exceptional service and effective cost control. Our success is driven by a service philosophy based on integrity, competence, compassion, and a responsive management style. UHS has been recognized as a Fortune 500 company and is listed as one of Fortune’s Most Admired Companies. UHS’s Acute Care Division is comprised of 25 high performing hospitals and several ambulatory care facilities across the nation and prides itself on providing superior patient care. 

Job Summary:  The EDI Developer supports and improves business processes with information technology solutions. Develops, designs, and analyzes systems and/or programs of complex scope and complexity to handle Industry Standard EDI and other data exchange/integration and various reporting requirements.  Responsibilities include creation and maintenance of maps to translate data from one source to another, whether internal or external. Utilization of SSIS and other similar tools to manage and manipulate data as required to meet integration requirements. The EDI Developer is responsible for implementation and integration of data between the health plan and its trading partners. This position is focused on the implementation of new electronic health care transactions, modification of existing solutions as requested and to improve stability and accuracy. This role will be responsible for mentoring, outreach, education, and implementation to facilitate and optimize electronic commerce. Knowledge and experience with HIPAA Code Sets and ANSI X12 transactions for healthcare is essential.

Job Requirements

Regulatory Requirements:

  • Bachelor degree and six years of experience in a related technical/business field OR Associate degree and eight years in a related technical/business field OR ten years of industry related technical/business experience.

  • Six or more years of strong experience with EDI and Data Extraction support utilizing data tools, various communication protocols and ability to read, understand and implement mapping specifications and standards.

  • Six or more years of strong experience with  ASC X12 EDI standards such as 834, 835, 837, 270/271 and other HIPAA transaction code sets.

  • Two or more years of experience working with QNXT® from TriZetto is preferred.

  • Two or more years’ experience working for a Healthcare Insurance company.

  • At least 2 years of experience with SQL, utilizing SSIS and SSRS and other developer tools.

  • Strong experience regarding complex EDI programming, system design, data integration/mapping, analysis principles, and general business operations.

  • Experience with data warehouse management systems and transportation management systems is preferred.

  • Knowledge of project management standards, methods and techniques.

  • Ability to work independently and as a member of a team.

  • Ability to communicate effectively with users, project teams, and management.

  • General programming experience, preferably with Microsoft tools.

 

Language Skills:

  • Ability to effectively communicate in English, both verbally and in writing.

Skills:

  • Possess skills and experience to accomplish responsibilities listed above.

  • Excellent computer skills.

  • Experience and ability to apply continuous improvement techniques to information technology and related areas.

  • Ability to work within general work objectives regarding projects and team goals.
  • Skilled in  working on a variety of problems of moderate to large in scope and complexity where Analysis of the situation or data requires thorough identification of factors and analysis of impact.

  • Strong experience to read, analyze, and interpret business requirements, detailed technical specs, manuals and procedures.

  • Ability to respond to significant inquiries from users.

  • Ability to define problems, collect data, establish facts, and draw valid conclusions.

  • Ability to effectively demonstrate team member competencies and participate in goal-setting, performance feedback, and self-development activities

 

Recommended skills

Management
Asc X12 Standards
Electronic Data Interchange
Information Technology
Health Care
Systems Design
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Job ID: 100990

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