Senior EDI Developer

Mass General Brigham•Somerville, MA

2d•$93,954 - $136,739•Hybrid

About The Position

Mass General Brigham Health Plan is seeking an experienced EDI Developer responsible for the design, development, implementation, and ongoing maintenance of healthcare EDI solutions supporting HIPAA transactions, including but not limited to 270/271, 276/277, 278, 820, 834, 835, 837, and 999. The ideal candidate has a strong understanding of HIPAA EDI implementation and companion guides used across the healthcare industry to ensure compliant and reliable data exchange. The EDI Developer must have hands-on software development experience and demonstrate the ability to follow established design principles, coding standards, and best practices. The role works closely within cross-functional project teams, adhering to SDLC processes throughout the lifecycle of development, testing, deployment, and support. Strong technical proficiency is required, including C#/.NET development, SQL and related tools such as SQL Server Management Studio (SSMS), SSIS, T-SQL, and experience working with Microsoft SQL Server. Experience using Visual Studio and BizTalk Server in support of EDI and integration workflows is essential. Experience within healthcare payer environments is highly valued. Preferred qualifications include exposure to QNXT (claims and enrollment processing systems), ASP.NET development, and XML/XSLT programming, which support complex EDI transformations and integrations.

Requirements

At least 5-7 years of experience in application development and design required.
At least 3-5 years of experience in application development, support and maintenance in a dynamic, Microsoft environment.
Experience required in SSIS packages, ANSI X12, XML, HL7 formatted EDI transactions preferred.
Understanding of the data dependencies that exist between applications and systems.
Experience with the development and support of intra-application data exchanges, job scheduling, and inter-job dependencies.
Demonstrated ability to develop customized solutions to meet business requirements.
Must have demonstrated ability to interact effectively and maintain productive interpersonal relations.
Accountable for delivering high-quality work.
Respects the talent and unique contribution of every individual.
Understanding of core programming principles, including design.
Ability to work in at least one programming language (ex: JavaScript, SQL, etc.).
Strong analytical, programming, and demonstrated project management skills.
Excellent communication skills, both written and oral.
C#/.NET development
SQL and related tools such as SQL Server Management Studio (SSMS), SSIS, T-SQL
Experience working with Microsoft SQL Server
Experience using Visual Studio and BizTalk Server in support of EDI and integration workflows

Nice To Haves

Bachelor's Degree preferred; experience can be considered in lieu of a degree.
Healthcare systems related experience preferred.
Experience with QNXT and CCA or other Integrated HealthCare Systems.
ASP.NET, C# and SharePoint Applications preferred.
Exposure to QNXT (claims and enrollment processing systems)
ASP.NET development
XML/XSLT programming

Responsibilities

Programming, including writing T-SQL in SQL Server and SSIS packages, which support the Vendor Interfaces.
Analyze business and system requirements, including impact analyses on existing systems, to develop systems specifications.
In partnership with the business units, design, prepare and execute unit test plans for application upgrades and enhancements.
General data mapping of ANSI HIPAA EDI files, including coding, translation, development, testing and deployment or EDI applications.
Perform analysis on systems and processes to become a subject matter expert, in order to help and support the business units.
Work with hosted vendors to accomplish SDLC objectives.
Provide data analysis support for NHP business areas in order to assist with the business areas’ information, reporting and application development needs.
Data analysis entails understanding the flow of data and its interdependency among QNXT core modules such as Member - Enrollment and Services, Claims Processing, Provider Relations, Clinical Systems and Finance.
Track and monitor problem tickets to insure timely resolution.
Communicate status and escalate issues as needed.
Identify and resolve problems related to business processes and applications.
Coordinate and/or perform change and revision management to ensure inter-operability of systems.
Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
Assist in requirements gathering with end users to clearly define information needs and translate those requirements into specifications for development.
Participate in change management, disaster recovery and production support operations.
Coordinate technical support and software upgrades with in-house staff and outside vendors to ensure NHP applications are performing effectively.