Healthcare EDI Systems Analyst III

Job Summary:

The Healthcare EDI Systems Analyst III is responsible for leading research and analysis to identify systems impacted by requirements, possible interfaces, cross team dependencies and affected lines of business.

Must Haves:

  • System analyst experience
  • Agile experience writing features/stories and acceptance criteria
  • Experience with mapping EDI Transactions from X12 to other formats and comparing implementation guides/companion guides (837, 835, 820, 834, 270/271, 276/277, 999, TA1, 277U, CCDA)
  • Hands on experience writing technical design documents and data/system flow documents
  • Ability to create X12 Test Data and sample data
  • Excellent organizational and interpersonal skills

Essential Functions:

  • Leverage appropriate approaches and modeling techniques to elicit requirements
  • Recognize inconsistencies and gaps in a complex business process
  • Assist in planning activities and development of business case documents
  • Through research and analysis, identify systems impacted by requirements, possible interfaces, cross team dependencies and affected lines of business
  • Translate business needs and technical requirements by authoring clear agile stories and features
  • Serve as a liaison between technical teams and users, stakeholders.
  • Perform root cause analysis
  • Build, sustain, and leverage relationships with persons within his/her area of immediate responsibility
  • Assist QA in preparation of test scenarios and test data
  • Sets objectives for own job with the understanding of how output would affect and impact other job areas related to own job. Contributes and provides input to the development of operational area goals within the context of own job area. Work consists of tasks that are typically not routine, works independently and applies discretion within established operational boundaries and procedures. Work direction is only provided for new areas of work or unique assignments.
  • Problems and issues faced are vague and require reasoning and analysis to address problems and issues. Updates and/or modifies work methods based on past experiences and identifies solutions to problems by recognizing similarities through data trends. Has higher autonomy to arrive at solutions to non-routine problems within established operational boundaries and procedures. Uses personal experiences, makes reasonable judgment calls, and may call on other resources where necessary to identify solutions.
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s degree in Computer Science, Information Systems, Business Administration or related field or equivalent years of relevant work experience is required
  • Five (5) years of experience in requirements management is required
  • Five (5) years of experience working in Facets, CCA, SAP, CRMs or other similar enterprise systems is required
  • Familiarity with the healthcare environment (Medicaid/Medicare) is required
  • Experience designing interfaces and/or mocking up user interfaces to support and display the information in multiple UI disciplines (Web, Mobile, Client Server, etc.) is required
  • Hands on Edifecs experience (XEServer, Specbuilder, Transaction Manager) preferred

Licensure and Certification:

  • Certifications around our core technical systems is preferred; Facets, CCA, SAP,CRMs or other similar Enterprise systems that mimic those CareSource invests in
  • Certifications around Agile, SAFE, or the Business or System Analyst role is preferred