Senior Edifecs Developer

CGI Deutschland•Raleigh, NC

2d•Hybrid

About The Position

We CGI is seeking an experienced Edifecs professional to support the design, configuration, and implementation of health plan enrollment and eligibility processes, with prior experience on the Edifecs Enrollment Management Solution (ENR) preferred. The ideal candidate will have hands-on experience with Edifecs tools and frameworks such as EAM, Spec Builder, and enrollment transaction processing (e.g., 834), and will work closely with business, integration, and QA teams to deliver accurate, compliant, and scalable enrollment solutions. This role requires a solid understanding of healthcare payer operations, strong analytical and troubleshooting skills, and the ability to translate business enrollment requirements into effective Edifecs-based implementations. This position can be located in Hartford, CT, Raleigh, NC, Lafayette, LA, Austin TX or Dallas, TX in a Hybrid model.

Requirements

At least 8+ years of relevant experience with strong hands-on expertise in Edifecs and healthcare EDI solutions.
Strong hands-on experience with Edifecs tools including XEngine, SpecBuilder, TPM, and XEServer.
In-depth knowledge of HIPAA EDI transactions (834, 837, 835, 270/271, 276/277, 278).
Experience with EDI mapping, validation, testing, and compliance.
Familiarity with integration technologies such as APIs, MQ, SFTP, and web services.
Working knowledge of relational databases (MS SQL, PostgreSQL).
Strong troubleshooting, production support, and performance tuning skills.

Nice To Haves

Experience with Edifecs Enrollment Management Solution (ENR).
Healthcare payer/provider domain experience.
Understanding of enrollment, eligibility, claims, benefits, and billing workflows.
Cloud deployment experience (AWS preferred).
Familiarity with DevOps and CI/CD tools such as Git, Jenkins, and related automation frameworks.

Responsibilities

Design, develop, configure, and support EDI solutions using the Edifecs platform (XEngine, SpecBuilder, XEServer, TPM, etc.).
Implement and support HIPAA X12 transaction sets including 834, 837, 835, 270/271, 276/277, and 278.
Collaborate with business analysts, solution architects, and clients to gather and translate healthcare and EDI integration requirements.
Configure, maintain, and support trading partner relationships to ensure accurate and timely data exchange.
Analyze, troubleshoot, and resolve EDI transaction errors across development, test, and production environments.
Perform EDI map development, validation, testing, and compliance checks using Edifecs tools.
Ensure solutions comply with HIPAA, X12, and industry standards.
Monitor EDI processes, provide Level 3 production support, and prioritize issues based on business impact.
Integrate EDI solutions with downstream systems using REST/SOAP APIs, MQ, SFTP, and other middleware technologies.
Create and maintain technical documentation including mappings, partner configurations, and system changes.
Participate in production deployments, release planning, and post-deployment support.
Build and support real-time monitoring, metrics, and alerts across applications.
Contribute to DevOps and automation initiatives to improve deployment and operational efficiency.