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IT SYSTEMS TECHNICAL SPECIALIST

Lead EDI Specialist

Recruitment #19-006659-0001

GRADE

19

LOCATION OF POSITION

750 East Pratt Street, 6th Floor, Baltimore, MD 21202

Main Purpose of Job

The main purpose of this position is to provide highly technical health care analysis to meet operational requirements and support management decision making and strategic planning. This position also requires the analysis of EDI files from the Carriers and MCOs, performance of root cause analysis for exceptions and performance of data changes to fix consumer or system reported errors, coordination with technical and business teams to analyze error reports, access HBX database and application to perform root cause analysis for transaction rejections. This position performs ad-hoc data analysis and develops as needed reports and data transformation for internal management use or for external stakeholders. This position provides guidance on resolution of Operational issues with various data files as part of day to day operations of the Exchange.

POSITION DUTIES

• Work for the EDI Operations team to provide EDI related services for the Exchange.
• Perform 8001 Flat File validation and analysis; review multiple MPIs for SSN matching.
• Perform HBX System Error analysis. Validate 1095-A and 1095-B files, reconcile 8001 transactions.
• Analyze EDI files sent to and received from Carriers/Managed Care Organizations (MCO) and identify errors and root cause for EDI file rejections.
• Design, develop and maintain queries and reports utilizing agency data.
• Research, evaluate and identify effective solutions for challenging and complex problems. 
• Evaluate and validate data accuracy & data fixes.
• Perform Data analysis & validation on the new implementation.
• Work collaboratively and coordinate with cross functional teams and complete work within established deadlines.

MINIMUM QUALIFICATIONS

Education: Bachelor’s degree from an accredited college or university in Computer Science, Computer Information Technology, Management Information Systems or other information technology-related field to include coursework in application, communication, database or operating systems software technology.
Experience: Three years of experience designing, developing, testing, implementing and maintaining application, communication, database or operating systems software.

Notes:
1. Graduation from an accredited high school or possession of a high school equivalency certificate and thirty credit hours from an accredited college or university in Computer Science, Computer Technology, Management Information Systems or other information technology-related field to include coursework in application, communication, database or operating systems software technology may be substituted for the required education.
2. Graduation from an accredited high school or possession of a high school equivalency certificate and one additional year of experience designing, developing, testing, implementing and maintaining application, communication, database or operating systems software may be substituted for the required education.
3. Experience operating computer systems; or scheduling, controlling input and output to process data on computer systems; or evaluating, implementing and maintaining computer hardware and software; or converting data from project specifications by developing program code using generally accepted computer programming languages may be substituted for high school education on a year- for-year basis.
4. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer in the Computer Systems Operations classifications or Computer Systems Operations specialty codes in the Information Technology field of work on a year-for-year basis for the required experience and education.

DESIRED OR PREFERRED QUALIFICATIONS

 Desired or Preferred Qualifications:

  • Two years of experience with Health Exchange EDI solutions.
  • Two years of experience in creating EDI X12 files for transactions sets such as 834, 999 and TA1.
  • Two years of experience in reviewing and understanding technical documents such as companion and implementation guides for Healthcare EDI formats 834 and 999.
  • Two years of experience in analyzing/testing Healthcare/Marketplace EDI Applications.
  • One year of experience working with SQL databases/queries.
  •  Experience leading teams in a professional environment  
  • Strong analytical and problem solving skills.
  • Excellent communication skills including the ability to understand and communicate technical information to business users, and gather business requirements that can be translated into technical requirements.
  • Ability to manage multiple critical priorities and tight deadlines.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties that require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator's license valid in the State of Maryland.

SELECTION PROCESS

The assessment may consist of a rating of your education, training and experience related to the requirements of the position. The rating may also be based on your application. Therefore, it is important that you provide complete and accurate information on your application. Report all education and experience related to this position. Qualified candidates will be rated as either Best Qualified, Better Qualified, or Qualified and placed on the eligible list for a period of at least one year.

For education obtained outside of the U.S., you will be required to provide proof of the equivalent American education as determined by a foreign credential evaluation service. If you possess a degree obtained outside of the United States, please submit a detailed, course-by-course evaluation report from one of the U.S. equivalency evaluating members identified at http://www.naces.org/members.html.

BENEFITS

FURTHER INSTRUCTIONS

The online application process is STRONGLY recommended.  However, if you are unable to apply online you may complete and submit a completed paper application along with the supplemental questionnaire (if applicable) to:

Jasciel Stamp

Maryland Health Benefit Exchange

750 East Pratt St., 6th Floor

Baltimore, Maryland 21202

If you have any questions concerning this position, please email:  jasciel.stamp@maryland.gov

Please make sure that you provide sufficient information on your application to show that you meet the qualifications of this recruitment.  All information concerning your qualifications must be submitted by the closing date.  We will not consider information submitted after this date.

As an equal opportunity employer Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.Bilingual applicants are encouraged to apply.We thank our Veterans for their service to our country, and encourage them to apply.

TTY  Users: call via Maryland Relay 1-800-735-2258.




Click on a link below to apply for this position:

Fill out the Supplemental Questionnaire and Application NOW using the Internet. Apply Online
View and print the Supplemental Questionnaire. This recruitment requires completion of a supplemental questionnaire. You may view and print the supplemental questionnaire here.
Apply via Paper Application. You may also download and complete the Paper Application here.