EDI Architect

 
Position: EDI Architect

Job ID: 144014

Location: US-TX-Houston

Department: APPLICATION SUPPORT

Talent Area: Information Services

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: Days

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for an EDI Architect – someone who works well in a fast-paced managed care or health plan setting. In this position, you’ll have a major role in providing lead technical services to analyze, design, and deliver EDI system solutions for all HIPAA related X12 transactions. Lends expertise to answer technical consulting questions, individually or as part of a project team. Serves as a senior subject matter expert associated with content, processes, and procedures associated with EDI HIPAA related X12 transactions Promotes consistency and collaboration with all functional departments with primary focus on optimizing all business processes supported by information technology and ensuring compliance with all State and Federal regulations.

This role will work with the Texas Children’s Health Plan and will office at our 610 and Bellaire location just south of the Galleria.

Think you’ve got what it takes?



Responsibilities :

  • Analyzes current business practices, user needs and work flow processes
  • Develops Architecture Specification deliverables/companion guides that map customer business requirements into complete information systems (technologies, processes and people) or operational solutions
  • Performs vendor analysis and make recommendations
  • Understands the customer's business problem, need, or opportunity and designs a virtualized solution that completely and correctly addresses the business problem, need, or opportunity
  • Leads the architectural design, development, deployment, and technical quality of large EDI enterprise solutions that span multiple technologies and disciplines
  • Devises or modifies procedures to solve problems considering system capacity, limitations, and desired results
  • Provides architectural direction for multiple medium to large sized projects concurrently in various stages of their lifecycle or a large project full time
  • Prior to first productive use, identifies the impacts and dependencies of the new system
  • Identifies and documents the data sources, recipients, and interfaces that need to be developed to support data collection and maintenance
  • Analyzes clinical & business use of existing systems to identify problem to be resolved and defines system applications or process improvements


Qualifications:

  • H.S. Diploma or GED
  • Bachelor's Degree in computer science, business administration, healthcare administration or other business or technology field preferred
  • Master’s Degree computer science, business administration, healthcare administration or other business or technology field preferred
  • 7 years of EDI architecture and design experience, including 3 years of experience in management of health insurance payor systems
  • Previous Health Plan Information Services experience preferred
  • Bachelor's degree in computer science, business administration, healthcare administration or other business or technology field may substitute for four (4) year’s experience. Master's degree in computer science, business administration, healthcare administration or other business or technology field may substitute for two (2) years experience
  • Broad IT industry knowledge including X12 transactions (270/271, 276/277, 834, 835, 837P, 837I, and 837D), and databases (SQL Server, MS Access)
  • Familiarity with Health Insurance business processes and practices. A working knowledge of a variety of hardware and software environments
  • A working knowledge of a variety of hardware and software environments
  • Process mapping, group presentation, written and verbal communication, analytical, and organizational skills
  • Ability to handle multiple projects simultaneously while adhering to a stringent timeline
  • Ability to apply knowledge of how the industry uses IT-EDI to address business challenges using, for example, technical standards and infrastructure, cross-industry trends that impact IT investment, industry-specific roadmaps, and IT enablers


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