Senior EDI SME

Essential Duties and Responsibilities

• EDI Subject Matter Expert (SME)
• Work with users and customers to document and strategize process improvements for current business processes (business process reengineering)
• Provide market research on conditions that impact the overall operational efficiency of the organization
• Identify areas for process improvement
• Respond to any VA related inquiries
• Assist internal team members and external stakeholders understand and interpret health data pertaining to claims and reference data sets
• Use data to address VA concerns, mission objectives, and legislative priorities
• Provide guidance to the project team regarding EDI requirements and testing
• Implement any changes or improvements

Required Skills and Experience

• Experience analyzing business, functional, and technical activities and events
• Technical experience in modern software development tools, cloud operations, and the VA DevSecOps Tool Suite, as well as VA Toolsets currently in use
• Application Life Cycle (ALM) tool experience preferred (Jira, GitHub, etc.)

Professional Certifications

n/a

Years of Professional Experience

20 or more years of related experience OR a Master’s Degree in a related scientific or technical discipline, and at least 10 years of related experience

Desired experience

• Experience working with the Department of Veterans’ Affairs
• Healthcare Claims X.12 Transaction (837, 835, 277, etc.)
• Health Data Exchange Standards (HL7, ASC X12 HIPAA (Transactions, Code Sets))
• Health Reference Data
• Medical Claims EDIs (834, 270, 271, etc.)
• Healthcare claims processing application knowledge
• Experience working in an Agile environment
• Experience with pharmacy standards

Formal Education

Bachelor’s degree in a related scientific or technical discipline; Master’s Degree strongly preferred

Citizenship Requirement

U.S. Citizenship required for this specific opportunity

Security Clearance Requirements

Must possess or qualify for a Public Trust (MBI)

CRITICAL NOTES:

1. SSG will not make assumptions regarding your qualifications. Your answers to the mandatory screening questions must be supported by the information on your resume.  Applications with inconsistencies will not be considered.
2. Recruiters or Third parties will not be considered
3. This is a New Mexico based position and is 100% remote.  Other U.S. based locations may be considered except for CA, CO, NJ, NY, which will not be considered.