Location: Remote within the continental U.S.
Duration: Approximately 24 months
Schedule: Monday–Friday, Pacific Time business hours
Industry: Healthcare / Medicaid / Managed Care
Description:
We are seeking an experienced X12 Healthcare Transaction Subject Matter Expert (SME) to support a large public-sector healthcare initiative involving provider information, managed-care network adequacy, healthcare data analysis, and X12 transactions.
Important: Candidates must clearly demonstrate at least 3 years of hands-on X12 transaction experience. Resumes that only mention EDI without identifying actual X12 experience may not be considered.
Mandatory Qualifications
Candidates must meet all of the following:
Minimum 5 years of full-time experience applying analytical processes on IT projects.
Bachelor's degree. Additional qualifying experience may substitute for education on a year-for-year basis.
Minimum 3 years of full-time experience in business systems analysis and design.
Minimum 3 years of experience working with program staff, management, and stakeholder relationship management.
Minimum 3 years of hands-on experience working with X12 transactions.
Preferred Qualifications
Strong preference for candidates with:
More than 3 years of healthcare X12 transaction experience.
Experience with X12 274 – Health Care Provider Directory.
Experience with transactions such as 270/271, 834, 835, 837, or related healthcare X12 transactions.
Healthcare data modeling experience.
Managed-care health plan experience involving Provider Information Data.
Medicaid/Medi-Cal or other government healthcare program experience.
Experience with healthcare claims and encounter-processing systems.
Experience preparing or contributing to budget-related documents or workbooks, including Advanced Planning Documents (APDs).
Responsibilities
Analyze healthcare provider-information and X12 transaction requirements.
Perform business systems analysis, requirements analysis, and gap analysis.
Review provider-data collection, reporting, and data-quality processes.
Identify data inconsistencies, anomalies, and process gaps and recommend corrective actions.
Support healthcare provider-directory and network-data initiatives.
Develop business and system requirements.
Work with business, technical, program, management, and external stakeholders.
Facilitate requirements-gathering and analysis sessions.
Develop documentation, analyses, recommendations, and status reports.
Provide X12 transaction subject-matter expertise and knowledge transfer.
Track project issues, risks, dependencies, and action items.
Required Candidate Submission
Please provide:
Current resume with month/year dates for all relevant positions and projects.
Specific X12 transaction numbers worked with.
Total years/months of X12 experience.
Education details.
Current location and availability.
Expected hourly rate.
Two professional references who can verify relevant work experience.
Important: Candidates must clearly demonstrate at least 3 years of hands-on X12 transaction experience. Resumes that only mention EDI without identifying actual X12 experience may not be considered.
Kiran Kumar
Key Business Solutions, Inc.
|| Office: 916 222 3188|| Fax: 916 646 2081 || Email:
