Director of EDI Development

Overview

The Director of EDI Development is responsible for evaluating design, development, and coordination of EDI projects and applications. Responsibilities include designing, coding, testing, and implementing each of the federal/state mandated electronic transactions and other applications; managing EDI developers and operations staff; and ensuring proper design principles and coding techniques are within the industry standards. Working closely with IT management and other department staff, performs requirements gathering, business and operational analysis related to EDI applications, and develops processes. Maintains functionality of hardware, software, and networking to support the day-to-day EDI functions and operations.

Responsibilities

• Designs, develops, and supports HIPAA compliant ANSI X12 EDI transactions and other application development projects as required, using appropriate tools and technologies such as Sybase’s Ec Map, Ec Gateway, Active Batch, SQL Server, Oracle, .NET, and Java.
• Manages EDI developers with design, testing, and implementation methodologies, ensuring proper design principles and coding techniques are within the industry standards.
• Manages EDI operations staff, oversees the day-to-day EDI operations, and assists in troubleshooting.
• Oversees planning and ensures resources are appropriate and available to support the EDI operations and development activities.
• Performs requirements gathering, business and operational analysis, and works closely with IT management and other department staff.
• Manages the testing of EDI transactions with Trading Partners and other certification authorities as mandated by the state and federal regulations.
• Manages the identification and development process to securely transfer EDI and HIPAA compliant transactions between PHC and Trading Partners.
• Maintains in-depth knowledge of HIPAA EDI 5010 TR3 technical specifications and the current HIPAA EDI rules from both technical and user perspectives.
• Develops policies and procedures to document PHC’s EDI operations
• Participates in negotiation of Trading Partner agreements and provides assistance to providers in preparing HIPAA compliant transactions for PHC.
• Creates and maintains documentation for all EDI projects and participates in team meetings, conferences, and problem solving discussions.
• Manages and motivates EDI development and operations staff members while maintaining cultural awareness/sensitivity.
• Actively participates and contributes to the strategic direction of long-term EDI technology roadmap, and designs new solutions to solve problems facing the organization.
• Maintains functionality of hardware, software, and networking to support EDI functions.
• Keeps abreast of new technologies and recommends those that would enhance staff and the use of technology to perform EDI functions more effectively.

SECONDARY DUTIES AND RESPONSIBILITIES

• Performs other assigned or needed activities required to assure success of the EDI development role and to support other work of the IT Department.

Qualifications

Education and Experience

Bachelor’s required or Master’s degree preferred in Computer Science,Business, or a related field preferred. At least five (5) years of lead ormanagement experience in Information Systems with a focus on EDIdevelopment in MS SQL Server and Oracle environment. Minimum five (5)years of experience in health care. Demonstrated experience with large,highly complex projects.

Special Skills, Licenses and Certifications

Substantial experience with EDI and knowledge of translators such as Sybase Ec Map and Database Development with Oracle 10/11g, SQL Server 2005 and/or 2008 is required. Experience with Sun’s Java and Microsoft’s .NET technologies such as VB.NET, ASP.NET, ADO.NET is preferred. Knowledge of scheduling systems is a plus. Certification in either the Microsoft or Oracle platform is plus. Knowledge of health care coding systems. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

Performance Based Competencies

Ability to quickly acquire in-depth knowledge of AMYSIS software and managed care issues. Strong written and oral communication skills with ability to interpret and understand technical requirements. Excellent analytical skills to troubleshoot and resolve systems problems. Attention to detail.

Work Environment And Physical Demands

More than 50% of work time is spent in front of a computer monitor. May be required to bend, stoop, kneel, crawl, or work in other non-standing and non-sitting positions to install cabling, systems hardware, and other related equipment.

All HealthPlan employees are expected to:

• Provide a high level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures as they may from time to time be updated.

HIRING RANGE:

$180,252.50 - $243,340.87

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Salary : $180,253 - $243,341