EDI Applications Architect for The Health Plan

 
Position: EDI Applications Architect for The Health Plan

Job ID: 144020

Location: US-TX-Houston

Department: TCHP IS 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 Application Architect – someone who works well in a fast-paced managed care organization setting. In this position, you’ll review application requirements, application and processing architectures and designs. You will develop, amend, optimize, and certify application and system design of Integrated Delivery Systems. Lastly, you will be responsible for the identification and resolution of the application information flow, the application integration and the required infrastructure to support application requirements.

 

This role will work with two different clients – the State of Texas which will set regulations and our Health Plan Organization who will be the internals who will execute what is needed. You will be responsible for retaining a broad view over new laws or regulations, and then advise on how to implement, test, and make sure these are working within the data flowing through the program. Can you figure out where data needs to go, and tell someone how to manage that? Familiarity with EDI 837 and 834 will be extremely helpful. You will be aiding programmers to understand what needs to be done once the regulations are understood. 

 

You must have good communication skills, and preferably some project management or team lead experience. It will be a plus to have a background in Managed Care Organizations (MCOs).

 

Think you’ve got what it takes?



Responsibilities :

  • Analyzes and coordinates designing of new & existing applications and architectures of Integrated Delivery System systems
  • Coordinates activities and information dissemination with manager, other Information Services personnel, users and vendors
  • Researches technology trends/directions
  • Coordinates/implements and controls the configuration and development of systems
  • Administers program and system tests
  • Develops system documentation
  • Prepares program code documentation in compliance with standards
  • Prepares system configuration procedures in compliance with standards
  • Controls system operations by finding and correcting errors in the system
  • Identifies and recommend tools and technologies using best practices/industry standards to support strategic direction and to assist in deploying appropriately business initiatives


Qualifications:

  • High school or GED
  • Ten (10) years major system design & implementation experience
  • EXPERIENCE OFFSETS: Bachelor’s degree will substitute four (4) years of work experience. Master’s degree will substitute for two (2) years of work experience
  • CLINICAL EXPERIENCE: Up to two (2) years of clinical patient care and/or clinical research experience may substitute for up to two (2) years of information systems experience on a month to month basis
  • Ability to demonstrate logic, analytical and effective verbal and written communication skills
  • Knowledge at expert level of current application and system development techniques


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