Engineer II - EDI (Remote Work Schedule)

Date: Jun 14, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 7292 

 

Position Summary/Position

 

The Engineer II – EDI manages the research and analysis of encounters and other EDI data and providing recommendations to team members in EDI team. These recommendations include, but not limited to providing guidance on analysis approach, rules development, workflow changes, communication protocols, data sources. The Engineer II – EDI must be able to work independently, often times working directly with business users and IT groups to understand and document requirements.

Major Functions (Duties and Responsibilities)

 

1. Comprehensive analysis of EDI underline data sources to determine the deficiencies for all LOBs
2. Provide recommendations for necessary changes in existing EDI processes
3. Monitor quality of data submitted to CMS and DHCS
4. Lead QA efforts for new or modified EDI processes
5. Guiding a team on topics related to encounters submissions to IEHP’s regulatory bodies, remediating submission errors.
6. Establish and maintain effective working relationships with others throughout the organization.
7. Incorporate LEAN principles into daily work.

Supervisory Responsibilities

Leading: Self

Experience Qualifications

 

4+ years in Healthcare EDI area. Experience with SQL programming. Experience working in a team-oriented, collaborative environment.

Education Qualifications

 

Bachelor's degree from an accredited institution required.

 

Significant experience may be considered in lieu of degree: In lieu of a degree, a minimum of 8 years of relevant work experience is required.

Preferred Education

 

Bachelor's degree preferably with a major in Information Technology, Mathematics, Business Administration, or Healthcare from an accredited institution.

Drivers License Required

No

Knowledge Requirement

 

Knowledge of IT SDLC Processes and QA practices. Excellent knowledge of Healthcare Industry. In depth knowledge of Healthcare HIPAA requirements and CA State and CMS regulations and X12 formats required. Expertise in SQL, SSRS – required. Knowledge of BizTalk, EDIFECS or similar tools is a plus.

Skills Requirement

 

Proficiency with Microsoft PC desktop applications including Excel, Word, Project, and Visio. Excellent analytical and problem-solving skills. Excellent organizational skills. Excellent written and oral communication skills. Excellent listening and interpersonal skills.

Abilities Requirement

 

A keen attention to detail. Ability to effectively prioritize and execute tasks in a high-pressure environment. Strong customer service orientation. A self-starter able to work effectively with minimal direct supervision.

Commitment to Team Culture


The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

Projects involving intensive work with computer keyboard and screens.

Work Model Location

Hybrid

 

Starting Salary: $79,809.60  - $101,774.40  

Pay rate will commensurate with experience

 

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 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and 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 state pension plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles