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EDI Analyst III

Company: Central California Alliance for Health
Location: Salinas
Posted on: October 8, 2019

Job Description:

We have an opportunity to join the Alliance as an Electronic Data Interchange (EDI) Analyst III in the Product Management Department.Please note: There is one position available and it can be filled in any of our offices: Merced, Salinas or Scotts Valley.

WHAT YOU'LL BE RESPONSIBLE FORReporting to the Analytics Manager, you will perform complex analysis and will be responsible for the solution design, development, testing, maintenance, and support for EDI interfaces and systems, both to and from the Alliance's trading partners and core business systems. You will support operational strategic objectives by analyzing business processes and functions, ensuring compliance with CAQH CORE Operating Rules, HIPAA and X12 standards and guidelines, gathers data, and evaluates input and output requirements and formats to formulate and implement final recommended solutions. You will research and resolve EDI errors and internal and external escalations regarding complex EDI related issues. You will prepare reports and diagrams and maintain companion guides and other supporting documentation by collecting, analyzing, and summarizing information and trends.


To read the full position description, and list of requirements click here.

  • Knowledge of:

    • ANSI X12 5010 837P, 837I, 835, 270/271, 274, 276/277 files and 999 Acknowledgment, 277CA, 278 and 834 transaction sets
    • Formal testing methodology, the principles and practices of test plan development and execution and documentation of test results
    • Current technology transmissions and receipt methods and the requirements of electronic data submissions
    • Software product lifecycle management from defining requirements to implementation
    • Advanced SQL
    • Data visualization concepts

    • Ability to:

      • Manage multiple projects simultaneously, organize work, maintain accurate records, respond to changing priorities and achieve goals and timelines
      • Track EDI issues, perform critical analysis of EDI issues and test results and deliver plans for resolution and solutions to problems
      • Manage and monitor the quality and timeliness of subcontractor's data submissions
      • Work collaboratively with individuals at all levels in a matrix organization while supporting stakeholders
      • Collaborate with project leads, business analysts, end users and third party contractors to design, develop, test, implement and document healthcare EDI solutions in an efficient and timely manner
      • Define issues, collect and interpret complex data, and develop solutions, project consequences of recommendations and prepare written reports

      • Education and Experience:

        • Bachelor's degree in Information Technology, Computer Science, Computer Engineering, Healthcare or a related field
        • A minimum of five years of business analysis experience in a Medi-Cal or managed care environment; or an equivalent combination of education and experience may be qualifying

          OUR BENEFITS

          • 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

            ABOUT USWe 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 or check out this video.

            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.

Keywords: Central California Alliance for Health, Salinas , EDI Analyst III, Professions , Salinas, California

Click here to apply!

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