Remote HIPAA EDI Developer

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry, focused on innovation, cost-effective care, and exceptional member experience. Job Summary MGB Health Plan is seeking an experienced EDI Developer responsible for designing, developing, and maintaining EDI solutions for HIPAA EDI transactions such as 270/271, 276/277, 278, 820, 834, 835, 837, and 999. The candidate must have a solid understanding of HIPAA EDI Implementations and Companion Guides, excel in software development practices, and work effectively in cross‑functional project teams following SDLC processes. Primary Responsibilities Write and maintain T‑SQL code in SQL Server and SSIS packages supporting vendor interfaces. Analyze business and system requirements, including impact analyses on existing systems, to develop system specifications. Collaborate with business units to design, prepare, and execute unit test plans for application upgrades and enhancements. Map ANSI HIPAA EDI files, performing coding, translation, development, testing, and deployment of EDI applications. Provide analysis support for NHP business areas, assisting with information, reporting, and application development needs. Understand data flow and inter‑dependency among QNXT core modules such as Member Enrollment and Services, Claims Processing, Provider Relations, Clinical Systems, and Finance. Track and monitor problem tickets to ensure timely resolution; communicate status and escalations as needed. Identify and resolve problems related to business processes and applications. Coordinate change and revision management to ensure interoperability of systems. Anticipate and meet internal and external customer expectations, establishing effective relationships and gaining trust. Assist in requirements gathering with end users to translate needed information into development specifications. Participate in change management, disaster recovery, and production support operations. Collaborate with in‑house staff and outside vendors for technical support and software upgrades to ensure optimal performance of NHP applications. Qualifications Education Bachelor’s Degree required (relevant experience may be considered in lieu of a degree). Experience At least 3–5 years application development, support, and maintenance experience in a dynamic Microsoft environment; healthcare systems experience preferred. Experience with QNXT, CCA, or other integrated health‑care systems, ASP.NET, C#, and SharePoint applications preferred. Proficiency in SSIS packages, ANSI X12, XML, and HL7 formatted EDI transactions. Knowledge, Skills, and Abilities Understanding of data dependencies between applications and systems. Experience with intra‑application data exchanges, job scheduling, and inter‑job dependencies. Demonstrated ability to develop customized solutions to meet business requirements. Strong interpersonal communication and interpersonal relational skills. Accountable for delivering high‑quality work and respecting diversity and individual contributions. Proficiency in at least one programming language (e.g., JavaScript, SQL). Strong analytical, programming, and project management skills. Excellent written and oral communication skills. Additional Job Details Working Conditions Position is remote; employees may be required to attend meetings, trainings, or other functions onsite as needed with reasonable notice. Remote Type Hybrid Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $62,836.80 - $89,762.40 Annual EEO Statement Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and other status protected under law. Disabilities requiring accommodation: Human Resources View phone number on click.appcast.io. At Mass General Brigham, we recognize and reward each team member’s unique value. Companion benefits and opportunities for professional growth and recognition are available. #J-18808-Ljbffr 8925 Mass General Brigham Health Plan Holding Company, Inc.