EDI Developer- Software Engineer III

Position Description

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

Responsible for one or more of the following: leading, planning and controlling projects; analyzing and designing solutions to business problems; programming new systems; maintaining existing systems; coordinating creation and change of data structures; integrating vendor packages; researching new tools, technologies, or platforms; thoroughly testing all program logic; and supporting the customer. --When analyzing and designing solutions, the incumbent is responsible for developing cost effective automated solutions that meet business requirements. To successfully accomplish this goal, close customer contact is required. The incumbent reviews current procedures/systems and proposes recommended solutions and alternatives to satisfy customer requests for system enhancements.

Responsibilities And Qualifications

• Design, implement, and manage EDI transactions and systems, ensuring accurate data exchange with business partners.
• Monitor EDI systems, troubleshoot issues, and perform regular maintenance to ensure optimal performance.
• Ensure data integrity and compliance with EDI standards and protocols throughout all data transactions and workflows.
• Analyze/research business problems to determine the impact on existing business and IT systems and procedures, as well as the feasibility of automation.
• Conforms with Project Management guidelines and procedures when developing IT solutions to defined business problems using structured methodologies. Conducts meetings with customers to ensure requirements are clear and solutions meet desired business needs.
• Designs innovative solutions using emerging and existing technologies for business problems and determines feasibility and practicality of implementation within current or future environments. This includes all processes required to support the accepted solution.
• Conducts program and system tests to ensure compliance. Assists customers in establishing acceptance criteria and effectiveness of proposed solutions.
• Maintains knowledge of the department’s programming languages and tools, coding and design techniques, data base management systems, processing platforms and emerging technologies through continued education and/or training.
• Analyzes functional and technical aspects of existing systems to identify areas where improvement can result in cost savings and improved quality and service.
• Acts as a focal point for problem resolution and customer inquiries.
  
  

Skills & Knowledge

• Experience with WTX/ITX or similar EDI data transformation software.
• Knowledge of integration patterns and the role of IBM Message Broker in integration
• Experience with EDI, ANSI, X12 standards, and HIPAA Transactions
• Familiarity with XML, JSON, CSV, Excel
• Knowledge of HIPAA Compliance Check tools and SNIP validation levels
• Ability to provide analysis from a ITX perspective on map functionality and design & implement new and updated maps.
• Knowledge of Linux and AIX platforms
• Must possess strong proven, hands-on experience and understanding of the EDI X12 transactions formats that govern healthcare Electronic Data Interchange (EDI)
• Working knowledge of accepted analysis and design concepts to resolve customer business problems.
• Working knowledge of database management technologies, data modeling practices and database platforms (e.g., Oracle, SQL Server) and data warehouse concepts
• Strong critical thinking skills to resolve defects/issues and facilitate troubleshooting of integration issues.
• Strong communication skills; effectively communicate (verbally and in writing) with all levels of Capital Staff and external contacts with professionalism (courtesy, persuasion, and tact).
• Strong organizational skills to prioritize workload, process multitasks, monitor project activities, and manage time effectively in an ever-changing health care environment.
• Ability to manage rapidly changing priorities and meet stringent deadlines with minimal supervision.
• Ability to provide off-hours assistance to support customers and I/T initiatives.
• Ability to work independently and/or as a member of a project team.
  
  

Experience

• Minimum of three years I/T experience; or an equivalent combination of experience and education.
• Ability to provide off-hours assistance to support customers and I/T initiatives.
• Ability to handle multiple assignments concurrently.
• Ability to adapt to changing priorities of multiple customers.
• Ability to work independently and/or as a member of a project team.
• Ability to effectively listen and communicate. Communication may include oral presentations, electronic communications, and/or written documents.
• Familiarity with the healthcare insurance industry.
  
  

Education, Certification, And Licenses

A Bachelor’s degree in Computer Science, Business Administration or related field

About Us

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.

And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.