Healthcare EDI Business Systems Analyst Senior

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Role Overview

Under the supervision of an IS Manager, the Healthcare EDI Business Systems Analyst Senior plays a critical role in resolving technical issues and coordinating the implementation of new releases. This position is responsible for managing standard operating procedures and ensuring effective communication related to a specific product or group of products. The Business Systems Analyst Senior establishes operational guidelines for maintaining products and provides exceptional communication and follow-through on client issues, serving as an advocate within internal departments. Additionally, this role leads teams involved in supporting essential operational activities ("lights-on" support) for designated products. Regular interaction with business partners, operations staff, consultants, external vendors, and other cross-functional team members is a key aspect of this position.

Work Arrangement

• This is a 100% Remote position

Responsibilities

• Provide business analysis support for all electronic data interchange (EDI) initiatives
• Perform systematic problem identification, detailed analysis, and effective resolution
• Break down complex problems into simple, manageable components for action
• Participate in, gather, and document business requirements and follow the standard system development life cycle process
• Develop system specifications and related documentation
• Participate in technical meetings and peer review sessions
• Recommend process improvements and enhancements, and actively participate on project teams to oversee their implementation
• Develop alternative approaches to issues and demonstrate the application of the most appropriate solution in each situation
• Provide ongoing production support for business systems
• Ensure compliance with HIPAA regulations
• Offer off-hours support as needed to meet customer service level agreements
• Coordinate issues that require vendor support and serve as the primary contact with vendor technical support teams
• Track the status of all open incidents and maintenance projects from initiation through to resolution
• Ensure that issues are addressed promptly and that customers receive regular updates throughout the resolution process
• Plan and manage the implementation of new software releases
• Coordinate application change management activities
• Demonstrate the ability to work independently with minimal supervision
• Attend relevant external system training seminars as needed, to enhance technical knowledge and abilities
• Act as a customer advocate, keeping customers informed of project progress from start to finish
• Foster and promote collaborative relationships with both internal and external customers  

Education and Experience

• Bachelor’s degree in computer science or equivalent and five (5)+ years of experience required
• At least five to seven (5 -7) years of relevant experience as a Business Systems Analyst in  healthcare IT (Medicare/Medicaid, Members, Providers, Claims, etc.) 
• At least five to seven (5 – 7) years of EDI X12 experience with a focus on healthcare transaction sets (837, 820, 835, 834, 270/271)
• Experience with SDLC - Waterfall / Agile, and Production Support
• Demonstrated leadership and issue resolution skills
• Proven track record of working successfully with customers, vendors, and leading cross-functional teams
• Strong orientation toward process, excellent problem-solving and troubleshooting skills, and a solid commitment to quality
• Outstanding communication skills, with the ability to interface with and influence various organizational levels
• Exceptional interpersonal skills, a high degree of self-motivation, and the ability to work independently

• Master's degree in MIS, Business Administration, or a related field preferred; Project Management Professional Certification from the PMI Institute or equivalent certification preferred

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.