Vendor and EDI Integrations

CorVel Corporation

10d•Remote

About The Position

The Vendor & EDI Integration is responsible for overseeing CorVel’s external data‑exchange ecosystem, including vendor integrations, clearinghouse partnerships, EDI/API connectivity, and Hub data services. This role drives the strategy, governance, and operational execution of all third‑party “bridges,” ensuring high‑quality, compliant, and scalable data exchange in support of bill review, provider networks, and enterprise operations. The position partners closely with IT Development, Product, Operations, and Legal to deliver reliable integrations, troubleshoot issues, accelerate onboarding, and expand CorVel’s integration capabilities. This is a remote role.

Requirements

Advanced understanding of EDI standards (X12), clearinghouse operations, secure file transport (SFTP/API), and data exchange frameworks.
Strong technical troubleshooting capabilities across file, API, and EDI workflows.
Experience with data mapping, validation rules, exception handling, and file reconciliation.
Excellent project management, communication, and vendor negotiation skills.
Ability to work cross‑functionally and manage multiple high‑priority initiatives simultaneously.
Strong organizational skills and detail orientation.
Bachelor’s degree in Business, IT, Engineering, or related field (or equivalent experience).
5–8+ years of experience in vendor management, EDI operations, integration management, or technical program management.
Proven experience with healthcare, workers’ compensation, or bill review integrations involving EDI and/or clearinghouse workflows.

Nice To Haves

Familiarity with CorVel systems a plus.
PMP, CSM, or related certification.

Responsibilities

Serve as business owner for all third‑party integrations
Lead vendor governance including SLAs, KPIs, QBRs, contract adherence, and roadmap alignment.
Oversee clearinghouse workflows and validation processes for EDI 837, 835 acknowledgments, error notifications, and provider submissions.
Ensure compliance with industry standards
Build scalable EDI ingestion, routing, validation, and audit processes across business units.
Lead implementation and continued enhancement of the integration model (API/EDI/file ingestion, acknowledgments, routing).
Oversee functional requirements including flexible layouts, acceptance/rejection monitoring, file acknowledgments, troubleshooting, and reporting dashboards
Partner with development teams to design scalable schemas, table structures, and intake processes aligned to enterprise integration standards.
Serve as escalation point for vendor, clearinghouse, and EDI issues, coordinating with internal and vendor technical teams.
Maintain mapping documentation, partner-specific schemas, and integration specs.
Support defect identification, root‑cause analysis, and remediation across all integration layers.
Lead client onboarding to existing bridges, ensuring consistent and scalable processes.
Drive discovery, requirements documentation, test file validation, UAT, cutover, and production readiness.
Maintain standardized implementation playbooks
Work with IT, Operations, Product, and Legal/Compliance teams to ensure integration readiness and support ongoing enhancements.
Communicate system updates, and partner readiness to internal stakeholders.
Support product demos, training, and documentation for internal and external users when required.