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Job Title: EDI Specialist

Job Location: Remote


Duration: Long term

Key Technology: SQL, SSRS, tabular/matrix reporting, SSIS, SQL Optimization,
Azure DevOps, Git 

 

Job Responsibilities:

Product, EDI & Adjudication Partnership Platforms role is a management role
responsible for working closely across the product management, operations, and
technology teams to ensure execution and delivery of initiatives focused on
electronic data interchange (EDI) and partnerships with Adjudication Systems.
Specifically, the Product Manager will be responsible for delivering
cross-product technology solutions to enhance the service experience for
stakeholders, including payers, providers, and members. The lead will own
driving the strategy for and development of a division wide EDI standardization
plan, building strategy around partner adjudication systems, Clearinghouse
consolidation, building monitoring and measuring plans, and, critically,
planning for how to use EDI and the existing and strategic partnerships as a
strength.

 

Key Responsibilities


Drive strategy for and development of a cross-product EDI solution,
especially focused on adjudication system partnerships, to drive an optimal
experience for payers, providers, and members
Inventory current EDI / Adjudication partners and assess current state gaps
and needs
Provides subject matter expertise in areas including EDI utilization for
development, workflows, use cases, user interface design, and specifications.
Lead and drive delivery of EDI and strategic partnerships by working with
shared services teams; responsibilities include identifying and managing
cross-team dependencies to align on the release schedule, proactively
developing solutions, delivering platform requirements and defining acceptance
criteria.
Manage customer needs for platform enhancements and improvements; and
proactively develops solutions to meet a diverse client base
Partner closely with operations and IT on potential platform migrations:
assess business case, perform gap analysis
Prepare and communicate program level status reporting to key constituents,
stakeholders, and executive team
Actively contribute new ideas and support ad hoc projects, including
time-sensitive requests
Accurately scopes out projects, sets objectives and goals, develops
schedules, measures performance against goals, and evaluates results
Responsible for creating and maintaining any collateral documentation such
as release notes, training guides, etc.
Responsible for creating and maintaining client and market focused
collateral explaining experience and use cases for outside distribution
Responsible for thought leadership market communication (e.g., articles,
webinars, posts) to help sell our vision on why the integration of the member,
provider, and payer is key to a well delivered overall solution
Mentor staff and team members to ensure alignment with goals
Ensure compliance with HIPAA regulations and requirements.
Maintain awareness of and ensure adherence to standards regarding privacy
Skills and Experience Required:


10+ years of product management or product delivery experience
Experience driving specifications, delivery, and design for utilizing EDI
Experience with managing partner relationships, particularly in the
adjudication space
Experience with UI and UX
Familiarity with Agile software development
Background and / or understanding of the healthcare industry
Reference : EDI Specialist jobs

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Published at 06-03-2023
Viewed: 91 times