EDI and Interoperability Analyst PCHP

Parkland Health

About The Position

Responsible for the design, implementation, maintenance, and monitoring of electronic data interchange (EDI) and healthcare interoperability processes to ensure secure, accurate, and timely exchange of healthcare data between Parkland Community Health Plan (PCHP) and internal or external partners. This role supports payer operations by managing standardized healthcare transactions, APIs, and interfaces in compliance with HIPAA, CMS, and state-specific requirements. The analyst collaborates closely with internal IT teams, vendors, clearinghouses, and business stakeholders to ensure continuity of operations, data integrity, and regulatory compliance across all interoperability workflows.

Requirements

Three (3) years of experience supporting EDI, healthcare interoperability (HL7/FHIR), or data integration solutions in a production environment
Three (3) years of experience supporting HIPAA transaction sets (834, 837, 837, 835, 820, 999/277CA)
Three (3) years of experience troubleshooting EDI transaction failures, reconciliation issues, and partner connectivity problems.
Experience working in a healthcare payer, managed care organization, or healthcare IT environment.
Bachelor’s degree in Computer Science, Information Systems, Health Information Management, or a related discipline.
Seven (7) additional years of progressively responsible healthcare EDI or interoperability experience may be considered in lieu of a degree.

Nice To Haves

Experience using Fortra GoAnywhere MFT or MoveIT is a plus !
EDI or Healthcare Interoperability certification (e.g., HL7)
HIPAA or Healthcare Compliance training/certification (will be obtained at Parkland)
Project Management training or certification (PMP preferred)

Responsibilities

Acts as a specialist in data pipeline development, ensuring scalable, reliable, and secure integration of healthcare data across systems.
Designs, implements, and supports EDI and interoperability solutions for healthcare transactions
Maintains EDI environments, partner integrations, and secure data exchange processes
Monitors daily EDI transaction flows and ensures timely resolution of rejected, failed, or suspended files
Troubleshoots and resolves EDI, connectivity, and data validation issues in collaboration with internal teams, vendors, and trading partners
Ensures compliance with HIPAA, CMS, and state regulatory requirements for all data exchanges
Coordinates onboarding, testing, and certification of new trading partners and interfaces
Participates in system upgrades, regulatory changes, and new regulatory mandates impacting interoperability
Provides on-call or after-hours support for critical EDI cycles as required
Documents operating procedures, mappings, companion guides, and support runbooks
Identifies opportunities to improve data exchange reliability, automation, and monitoring
Collaborates with analytics, claims, enrollment, and provider teams to support business operations
Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP.
Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.