Healthcare EDI Integration Analyst

At Zelis, we Get Stuff Done. So, let's get to it!

A Little About Us
Zelis is modernizing the healthcare financial experience for all by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts-driving real, measurable results for clients.

A Little About You
You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview
The Healthcare EDI Integration Analyst will play a critical role in our organization by ensuring seamless integration of Electronic Data Interchange (EDI) processes. The ideal candidate will have a strong technical background, excellent analytical skills, and a deep understanding of healthcare EDI transactions, specifically 837I and 837P. This role requires proficiency in reading and interpreting code written in SQL, Java, C#, and .NET, as well as experience with Jira for project management and story writing.

What You'll Do

• Analyze and document EDI integration solutions to support business processes and requirements.

• Read and interpret code written in SQL, Java, C#, and .NET to troubleshoot and enhance EDI processes.

• Ensure full compliance with healthcare EDI standards, including 837I and 837P transactions.

• Collaborate with cross-functional teams to gather and document business requirements, translating them into detailed user stories and subtasks in Jira.

• Develop and maintain comprehensive documentation, including process flows, data mappings, and technical specifications.

• Utilize logical thinking and problem-solving skills to identify and address integration challenges.

• Leverage knowledge of webMethods to enhance EDI integration processes (preferred but not required).

• Develop use cases, technical research, and customer feedback into program/technical requirements for execution by our development group.

• Support and assist with the development of test cases and test plans.

• Write clear and concise documentation and project artifacts to facilitate ongoing operations.

• Lead customer Enterprise and trading community Ecosystem data integration activities.

• Properly document, communicate, and enforce project deliverables, roles, milestones, and timelines.

• Provide project management and operational support to the Development and Solutions Delivery team.

• Perform root cause analysis and design solutions for complex problems, leveraging SQL and other tools.

• Deep dive into different business areas to deliver workflow optimization through electronic data exchange.

• Continuously set and manage external and internal customer expectations.

• Lead integration requirements capture sessions with business and customer stakeholders.

What You'll Bring to Zelis

• Requires 5 years EDI experience (Bachelor's degree preferred).

• EDI HealthCare industry with an in-depth understanding of healthcare EDI transactions, specifically 837I and 837P required.

• Proficiency in reading and interpreting code (SQL, Java, C#, .NET, C, or C++).

• Ability to write and run complex SQL queries.

• Experience across a range of integration approaches, including streaming, EDI, API, JSON, XML, and/or flat file integration.

• Knowledge of webMethods is a plus.

• Knowledge of Jira for project management, story writing, and task tracking.

• General understanding of the software development lifecycle and management of technology.

• A strong facilitator who can work with Subject Matter Experts (SMEs) to gain operational knowledge at a detailed level quickly.

• Awareness of healthcare regulations like HIPAA and ability to ensure EDI data exchange adheres to compliance standards.

• Knowledge and experience working in Agile development methodology, and an ability to meet release cadence milestones.

• Strong writing skills with the ability to create clear and concise documentation.

• Excellent analytical and logical thinking skills.

• Strong communication and interpersonal skills, with the ability to collaborate effectively with cross-functional teams.

• Detail-oriented with a commitment to accuracy and quality.

• Exceptional written communication skills for technical user story development.

• Ability to manage multiple priorities and adapt in a fast-changing environment.

• Familiarity with analytical tools, such as spreadsheets, business intelligence applications, and SQL.

Location and Workplace Flexibility:

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients.

Commitment to Diversity, Equity,Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.

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