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Developer III - EDI

Date: Aug 9, 2019

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

 

 

Position Summary/ Purpose

 

Under the direction of the EDI Technical Manager, the EDI Developer III is responsible for design, development and implementation of all enhancements and new systems as well as analysis and reporting related to Claims, Encounters, Eligibility, Pharmacy and other EDI systems and processes.

 

A level III developer is expected to mentor other members of the team on development standards, best practices, quality and deliverable timeliness.

 

Major Duties and Responsibilities

 

  1. Design and development of solutions related EDI processes.
  2. Collaborate with other IEHP departments and data stewards to assess and prioritize needs, and assist with developing strategies, plans, policies and procedures related to providing effective EDI solutions.
  3. Design and implement effective solutions by utilizing best practice approach, making sure that new code is source saved and reviewed prior to implementation.
  4. Participating in interviews, surveys, brainstorming sessions, storyboarding, prototyping, and use cases.
  5. Mentor other members of the team on data quality, data completeness, data accuracy, and deliverable timeliness are built into every reporting solution.
  6. Manage and prioritize user requirements to help manage overall project scope.
  7. Discover, explore, analyze and document data from all source and target systems to better understand the total scope of data availability at IEHP.
  8. Design, develop and implement processes and systems related to Encounters and other EDI processes.

  9. Identify and communicate issues and risks to management in a timely manner.
  10. Contribute to development and enforcement of IEHP standards.
  11. Gathers, analyzes requirements and develop processes and reports to meet business requirements.
  12. Establish and maintain effective working relationships with others throughout the IEHP organization.
  13. Demonstrate a commitment to support IEHP’s strategic priorities to become a 5-Star Health Plan and incorporate LEAN principles into daily work.
  14. Any other duties as required to ensure Health Plan operations are successful.
  15. Ensure the privacy and security of PHI (Protected Health Information) as outlined in IEHP's policies and procedures relating to HIPAA compliance.

 

Minimum Qualifications

 

Six (6) or more years in systems design, development and implementation of complex data driven processes.   Experience in report writing and analysis.  Experience in database design, query development, table joins and report development and creation.  Data analysis experience in the areas of medical or health services preferred.

 

Bachelor's degree from an accredited four year institution required, Master's preferred.  6 - 10 years experience required.

 

Strong data analysis, strong development experience,  and database capabilities. Strong expertise in Microsoft SQL Server, .Net, Database design.  Knowledge of EDI standards.

Pay Range: $98,612  - $152,921 

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 1,700 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

 

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