In this mission critical role, you will work closely with a dynamic team of EDI analysts and developers to design, develop, implement and maintain EDI-centric business applications and data automation processes. You will bring your knowledge of healthcare HIPAA 5010 Transaction sets (e.g. 834, 835, 837, 820, 270/271, 276/277 and 274) and experience developing Microsoft BizTalk applications using HIPAA mappings in BizTalk to author functional and technical specification documents and design and create SQL stored procedures and user-defined functions. You will serve as an SME for the common codebase, providing direct support where you are most familiar, and continually learning and adopting where you may be least familiar.
WHAT YOU WILL DO
- Work with EDI analysts to clarify and approve requirements and business rules.
- Validate and clarify business requirements, particularly those in SFHP’s companion guide and drive the transition to technical design.
- Design, develop, implement, and deploy solutions that support EDI transactions and processes
- Create and execute unit, integration and regression test plans based on system and validation requirements.
- Troubleshoot, optimize, and tune solutions and batch processes supporting EDI transactions
- Document all work-products, per SFHP’s best practices and standards.
- Maintain existing code and fix bugs whenever needed.
- Ensure smooth functioning of our development, QA, and production environments.
- Collaborate with functional business units to gather business and technical requirements.
- Conduct data analysis, identify issues and recommend and implement solutions.
WHAT YOU WILL BRING
- A Bachelor’s degree in Computer Science or equivalent work experience.
- 5-7+ years of Microsoft BizTalk 2013R2/16 developing within the context of an application lifecycle to support enterprise-wide or department-wide business processes.
- 5-7+ years of advanced SQL Server 2014 or higher experience.
- Experience with EDI/X12 file formats.
- Experience with at least one SDLC process/methodology (e.g., AGILE, SCRUM, Waterfall)
- Strong understanding of Edifecs, or like product, to support EDI orchestration and integration to business applications & processes
- 3-5+Years of QNXT/QConnect preferred
- PC literacy with strong MS Office skills (Outlook, Word, Excel, PowerPoint)
- Experience in data analysis, data modeling (particularly OLTP design, 3rd normal form).
- Strong organization, time management and multi-tasking abilities.
- Strong collaboration ability, impeccable organization skills and fortitude to work well under pressure when needed.
- Familiarity with industry standard health data code sets such as ICD-9/ICD-10, CPT/HCPCS, revenue codes, and NDC (Pharmacy).
Established in 1997, San Francisco Health Plan (SFHP) is a an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 145,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.
San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.