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Moda Health EDI Business Systems Analyst in United States

EDI Business Systems Analyst

Job Title

EDI Business Systems Analyst

Duration

Open until filled

Description

Let’s do great things, together!

About ModaFounded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position SummaryResponsible for project-driven activities related to the EDI support of business areas which utilize automated and manual systems through definition of business requirements, standardization and improvement of business practices, review of technical design and control of customer acceptance testing. This is a FT WFH position. Pay Range$67,414.37 - $87,658.81​​​ annually**Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27738943&refresh=trueBenefits:

  • Medical, Dental, Vision, Pharmacy, Life, & Disability

  • 401K- Matching

  • FSA

  • Employee Assistance Program

  • PTO and Company Paid Holidays

Required Skills, Experience & Education:

  • College degree in Computer Science, Mathematics, Business Administration or related field or equivalent work experience.

  • Minimum of 4 years of experience in the healthcare industry or in defining and analyzing business requirement, process modeling, functional systems design, and/or acceptance testing.

  • Experience with the business area that is supported by this position such as claims processing, membership accounting, provider relations, etc.

  • Knowledge of corporate operational functions or related equivalent in information technology.

  • Knowledge of system development, project methodology practices and deliverables.

  • Knowledge of technical tools available for file submissions, printing, output review on a working level.

  • Proficiency with Microsoft Office applications.

  • Knowledge of work methods and procedure writing.

  • Knowledge of existing systems and procedures.

  • Ability to demonstrate analytical skills and strengths in diagnosing complex problems and implementing systems.

  • Ability to work on multiple projects, production support tasks and other work items simultaneously as directed.

  • Ability to plan, organize, and prioritize assignments to ensure established guidelines and/or deadlines are met.

  • Ability to communicate effectively, verbally and in writing, with users, systems personnel, vendors, and management.

  • Ability to work both independently with minimal supervision and as a team member.

  • Ability to maintain confidentiality and project a professional business image.

Primary Functions:

  • Responsible for quality and continuous improvement within the job scope.

  • Responsible for all actions/responsibilities as described in organization-controlled documentation for this position.

  • Contributes to and supports the corporation’s quality initiatives by encouraging team and individual contributions toward the corporation’s quality improvement efforts.

  • Participates as a team member in defining the business requirements, modeling the business processes, defining functional system design, and conducting acceptance enhancements to those systems and other related systems.

  • Participates as a team member in the development of business cases, business contingency plans, business metrics and measurements, phase documentation, process models, capacity drivers, training materials, new procedures, acceptance test scripts, ad-hoc reports, improved “to-be” processes and success metrics.

  • Participates in the review and approval of system and screen designs, logical database schema, report design, interface design, and conversion plan.

  • Documents and/or approves high-level data flows, functional specifications, and system for implementation staging, change control, design alternatives and functional system requirements.

  • Collaborates with the system project teams in defining and documenting detailed business functional system requirements and in reviewing, analyzing, and approving acceptance test results from conversion, interface, and enhancement testing.

  • Works with the development team to ensure requirements are understood and met through technical design reviews.

  • Documents and triages bugs and issues during all testing phases

  • Responds to customer inquiries regarding functional system requirement design and modification as well as provides status information and general trouble shooting results to all users.

  • Assists in the training, motivation, and development of other analysts to obtain maximum efficiency of skills and resources within the unit.

  • Performs post implementation reviews to include fine tuning processes as needed by prioritizing and authorizing requests for enhancements and integrating help function with screens.

  • Performs post implementation quality assurance and troubleshooting. Develops both user and business unit technical documentation for system enhancements as needed.

  • Assists, when appropriate, in the training and communication of system changes for end-users and other impacted staff.

  • Acts in review and approval capacity in the establishment and maintenance of acceptance testing and prioritization of requests for system enhancements, system implementation.

  • Devises and documents test plans and outcomes at a level of details that allows research and analysis.

  • Provides definitions for interface needs, system functions, and conversion specifications.

  • Identifies and communicates goals, changes, organizational impacts, performance needs, maintenance issues, and new processes.

  • Performs problem solving daily and assists BSA team in generating effective and efficient solutions.

  • Manages the day to day EDI transactions such as monitoring and seeing them through their processes.

  • Manages internal and external communications.

  • Maintains a technical analyst level understanding of technology used by development team and how it relates to business operations.

  • Performs other duties as assigned.

Together, we can be more. We can be better. ​​​​​​Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.

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