Now is the time to join us! 

Who are you?

Your role involves coordinating implementation of 834, 837, and other proprietary eligibility and claims EDI processes, COB and group files for various health plans ensuring success configuring EDI processes, aligning data operations with key business priorities and deliverables. This role is technical, requiring an understanding of EDI processes, including eligibility, claims, and accumulators among others. You will work closely with Account Managers, Implementation Managers, clients, and their benefits partners, as well as the internal Data Operations teams responsible for execution.

In this role you will wear many hats, but your knowledge will be essential in the following:  

• Operational Leadership: Manage end-to-end project delivery for data operations teams, including requirements gathering, file specification development, execution, and monitoring.
• EDI Configuration Requirements: Work closely with internal and external partners, along with healthcare providers and payors to ensure all Inbound and Outbound EDI connections are setup properly, including coordinating resolution of any issues
• Change Management: Facilitate smooth transitions for changes to a client’s benefits
• Stakeholder Engagement: Collaborate with business leaders, data scientists, engineers, and other stakeholders to define project scope, objectives, and success criteria.
• Risk Management: Identify and mitigate project risks, ensuring timely resolution.
• Quality Assurance: Maintain high standards for data accuracy, consistency, and reliability.
• Reporting and Metrics: Provide regular updates on project status, milestones, and KPIs.
• Process Improvement: Continuously enhance data-related processes and workflows.
• Vendor Management: Coordinate with external vendors and partners as needed.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

What you bring to the Personify Health team:

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

• Completed a B.S./M.S. in Healthcare Administration, Project Management or relevant equivalent
• 5-9 years’ experience as an Implementation Manager, Engineer, EDI Specialist, Business Analyst or other related Medical Insurance Analyst roles

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

• The position requires the ability to coordinate and facilitate integration discussions with third parties, develop and maintain documentation, coordinate extensive testing with multiple parties and perform impact assessments
• Manage deliverables in JIRA, Confluence, and relevant tools
• Enjoy learning about new technologies and how they can be practically applied
• Determine and document EDI requirements, and confirm these meet customer needs by reviewing with internal and external stakeholders.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $70,000 to $95,000. Note that compensation may vary based on location, skills, and experience. This position is eligible for 10%  target bonus/variable compensation as well as health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#WeAreHiring #PersonifyHealth

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

Application Deadline: Open until position is filled.