Site: Mass General Brigham Health Plan Holding Company, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.
MGB Health Plan is seeking an experienced EDI Developer responsible for the design, development, implementation, and ongoing maintenance of healthcare EDI solutions supporting HIPAA transactions, including but not limited to 270/271, 276/277, 278, 820, 834, 835, 837, and 999. The idea candidate has a strong understanding of HIPAA EDI implementation and companion guides used across the healthcare industry to ensure compliant and reliable data exchange.
The EDI Developer must have hands‑on software development experience and demonstrate the ability to follow established design principles, coding standards, and best practices. The role works closely within cross‑functional project teams, adhering to SDLC processes throughout the lifecycle of development, testing, deployment, and support.
Strong technical proficiency is required, including C#/.NET development, SQL and related tools such as SQL Server Management Studio (SSMS), SSIS, T‑SQL, and experience working with Microsoft SQL Server. Experience using Visual Studio and BizTalk Server in support of EDI and integration workflows is essential.
Experience within healthcare payer environments is highly valued. Preferred qualifications include exposure to QNXT (claims and enrollment processing systems), ASP.NET development, and XML/XSLT programming, which support complex EDI transformations and integrations.
Primary Responsibilities:
-Programming, including writing T-SQL in SQL Server and SSIS packages, which support the Vendor Interfaces.
-Analyze business and system requirements, including impact analyses on existing systems, to develop systems specifications
-In partnership with the business units, design, prepare and execute unit test plans for application upgrades and enhancements.
-General data mapping of ANSI HIPAA EDI files, including coding, translation, development, testing and deployment or EDI applications.
-Perform analysis on systems and processes to become a subject matter expert, in order to help and support the business units.
-Work with hosted vendors to accomplish SDLC objectives
-Provide data analysis support for NHP business areas in order to assist with the business areas’ information, reporting and application development needs. -Data analysis entails understanding the flow of data and its interdependency among QNXT core modules such as Member
-Enrollment and Services, Claims Processing, Provider Relations, Clinical Systems and Finance.
-Track and monitor problem tickets to insure timely resolution
-Communicate status and escalate issues as needed.
-Identify and resolve problems related to business processes and applications.
-Coordinate and/or perform change and revision management to ensure inter-operability of systems
-Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
-Assist in requirements gathering with end users to clearly define information needs and translate those requirements into specifications for development.
-Participate in change management, disaster recovery and production support operations.
-Coordinate technical support and software upgrades with in-house staff and outside vendors to ensure NHP applications are performing effectively.
Education
- Bachelor's Degree required (relevant experience can be considered in lieu of a degree)
Qualifications
- Applications development experience required
- At least 3-5 years of experience in application development, support and maintenance in a dynamic, Microsoft environment. Healthcare systems related experience preferred
- Experience with QNXT and CCA or other Integrated HealthCare Systems - ASP.NET, C# and SharePoint Applications preferred
- Experience required in SSIS packages, ANSI X12, XML, HL7 formatted EDI transactions preferred
Knowledge, Skills, and Abilities
- Understanding of the data dependencies that exist between applications and systems
- Experience with the development and support of intra-application data exchanges, job scheduling and inter-job dependencies
- Demonstrated ability to develop customized solutions to meet business requirements
- Must have demonstrated ability to interact effectively and maintain productive interpersonal relations.
- Accountable for delivering high quality work
- Respects the talent and unique contribution of every individual
- Understanding of core programming principles, including design.
- Ability to work in at least one programming language (ex: JavaScript, SQL, etc.).
- Strong analytical, programming and demonstrated project management skills.
- Excellent communications skills both written and oral.
Additional Job Details (if applicable)
Working Conditions
- While this position is designated as remote, all employees, including those classified as remote, may be required to attend meetings, trainings, or other necessary functions onsite at a Mass General Brigham location on an as-needed basis. Reasonable notice will be provided for any required in-person attendance.
- M-F Eastern Business Hours required
- Flexibility for business needs to be onsite needed
- Remote workdays require stable, secure, quiet, compliant workspace
Hybrid
399 Revolution Drive
40
Regular
Day (United States of America)
Pay Range
$62,836.80 - $89,762.40/Annual
Grade
5
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.