EDI Technical SME

We are currently looking for a Technical EDI SME for a 100% remote position supporting a large federal government healthcare modernization project. This role will support the Department of Veterans Affairs (VA) by integrating the Fraud Waste and Abuse (FWA) tool with Community Care Development, Security, and Operations (CCDSO) products and other VA healthcare systems, including CCRS. The Technical EDI SME will assess system readiness, analyze healthcare transaction workflows, and define and implement integration strategies using ANSI X12 and other EDI-based data exchanges.

This role operates within a collaborative Agile DevSecOps environment, working with business stakeholders, architects, developers, testing teams, external trading partners, and VA leadership to support reliable, secure, and compliant healthcare data exchange.

The candidate must reside within the continental US.

Responsibilities

• Assess internal and external system readiness, analyze healthcare claims workflows, and define integration strategies connecting the VA FWA tool with CCDSO products, CCRS, and other VA healthcare systems.
• Build, configure, maintain, and enhance EDI maps, workflows, and integrations for transaction sets including 835, 837, and 277CA using mapping tools, translation software, and integration platforms.
• Implement trading partner setups, communication protocols, and document formats, coordinating with external partners to validate connectivity, transaction formats, and compliance.
• Monitor daily EDI operations, troubleshoot production integration failures, perform root-cause analysis, and provide timely technical support to resolve data discrepancies and minimize business disruption.
• Collaborate with business analysts, architects, developers, QA teams, and stakeholders on requirements gathering, solution design, testing, and production implementation, while maintaining documentation for EDI processes, trading partner requirements, and system configurations.
• Validate transaction data, implement error handling and quality checks, and support audits and compliance reviews to ensure data integrity and adherence to applicable HIPAA, ANSI X12, EDIFACT, and organizational requirements.
• Take on additional tasks and responsibilities as needed to support team objectives and ensure the success of the project.

Requirements

• Bachelor’s degree in computer science, computer information systems, engineering, or a related technical discipline, with eight or more years of healthcare integration experience.
• Deep expertise in healthcare EDI standards and transaction workflows, including ANSI X12 transactions such as 835, 837, and 277CA, HIPAA requirements, and familiarity with EDIFACT or XML-based formats.
• Strong understanding of integration architectures, EDI mapping and translation tools, APIs, SFTP/FTP, AS2, VANs, relational databases, and SQL.
• Experience integrating VA healthcare systems, including systems such as CCRS, and delivering solutions from initial concept through production implementation, with knowledge of version control systems and CI/CD pipelines and prior experience supporting high-volume transaction environments.
• Strong analytical, troubleshooting, and problem-solving skills, including experience resolving production integration failures, performing root-cause analysis, and prioritizing issues affecting data integrity and operational continuity.
• Strong interpersonal, communication, collaboration, and technical leadership skills, with the ability to work independently and collaboratively in a fast-paced Agile DevSecOps environment.

Additional Qualifications

• Experience with scripting or programming languages such as Java, Python, C#, or similar technologies.
• Experience integrating fraud, waste, and abuse tools with healthcare claims processing systems.
• Familiarity with VA Community Care workflows, CCDSO products, and federal healthcare modernization initiatives.

Security Clearance Requirements

• U.S. Citizenship is required.
• All selected candidates must successfully complete a background check.
• Ability to obtain and maintain a Government/Public Trust clearance, including required fingerprinting, when required for the position.

Benefits

• Medical/Dental/Vision
• 401k with Employer Match
• PTO + Federal Holidays
• Corporate Laptop
• Training Opportunities
• Remote Opportunity

VetsEZ is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status.

Sorry, we are unable to offer sponsorship at this time.