EDI Analyst - Database

BCBS Global Solutions; King of Prussia (PA); On-site; USD 90,000 - 120,000; Full time

Job summary

BCBS Global Solutions is seeking an experienced EDI Analyst to manage end-to-end 834 enrollment file implementations, working with vendors, clients, and internal teams. The role focuses on 834 v5010 EDI files, SDLC practices, and both Agile and Waterfall methodologies in a fast-paced healthcare enrollment environment.

The analyst will lead new EDI implementations, ensure data accuracy and security, coordinate testing, and provide production support as well as annual Open Enrollment readiness

Qualifications

• 5+ years hands-on experience with 834 EDI file builds.
• Expert-level experience with 834 v5010 files.
• Familiarity with BizTalk and Oracle integration platforms.
• Strong SDLC knowledge and best practices.
• Experience with Agile and Waterfall methodologies.
• Excellent communication and collaboration across teams.

Responsibilities

• Lead 834 EDI implementation projects from kickoff to production.
• Collaborate with vendors, clients, and internal teams.
• Configure 834 file requirements and ensure compliance.
• Validate 834 file structure and coordinate testing.
• Provide production support and issue resolution.
• Support annual open enrollment readiness and planning.

Skills

EDI 834

BizTalk

Logic Apps

SDLC

Agile

Waterfall

Data integration

Project coordination

Stakeholder management

Communication

Education

Bachelor's degree or equivalent experience

Tools

BizTalk

Oracle

Logic Apps

Job description

Who We Are.

At Blue Cross Blue Shield Global Solutions SM (BCBS Global Solutions SM ), we make it easy for people and organizations to access and pay for healthcare abroad. By combining digital innovation with human-centered care, we go above and beyond for our customers and deliver an international healthcare experience that’s simple, efficient, and human.

Who We Are.

At Blue Cross Blue Shield Global Solutions SM (BCBS Global Solutions SM ), we make it easy for people and organizations to access and pay for healthcare abroad. By combining digital innovation with human-centered care, we go above and beyond for our customers and deliver an international healthcare experience that’s simple, efficient, and human.

Whether our customers live, work, travel or study abroad, we give them the confidence and peace of mind to embrace every journey and say “yes” to new possibilities.

What we’re looking for in our EDI Analyst

The EDI Analyst will be responsible for managing the end-to-end lifecycle of Electronic Data Interchange (EDI) 834 enrollment file implementations, from initial project kick-off through production support. This role serves as the primary liaison between vendors, clients, internal development teams, and health plan enrollment operations to ensure accurate, timely, and compliant EDI data exchange. This role requires deep hands‑on expertise with EDI files, specifically with the 834 v5010 file format, and SDLC methodologies, including Agile and Waterfall. This position works collaboratively with cross‑functional teams to deliver high‑quality, scalable, and secure data solutions.

Responsibilities:

New EDI Implementations

• Project Meetings: Lead and participate in project kick-off meetings and recurring project status update meetings to align stakeholders on timelines, requirements, and deliverables.
• 834 Configuration Requirements: Partner with vendors and clients to gather, document, and finalize 834 file configuration requirements, ensuring specifications meet business and compliance needs.
• Cross-Functional Coordination:
• Work closely with BizTalk and Oracle developers to translate client configuration requirements into technical build specifications and ensure accurate implementation.
• Participate in the full SDLC, following established best practices for requirements analysis, design, development, testing, deployment and support.
• Apply Agile and Waterfall methodologies effectively, collaborating with project managers, product owners, business analysts, testers, etc.
• Ensure solutions adhere to security, compliance, performance, and scalability standards.
• Observe and follow all IT policies, procedures, and service level agreements (SLAs).

Testing & Validation

• Testing & Validation:
• Verify 834 file structure integrity through rigorous testing protocols.
• Coordinate testing activities and results review with vendors and clients.
• Review enrollment exceptions generated during testing and drive remediation efforts to resolution.

Production Support

• Production Support:
• Serve as a key point of contact for production issue resolution, coordinating across the BCBS GS Enrollment Team, EDI vendors/clients, and development teams to diagnose and resolve enrollment file issues in a timely manner.
• Support ongoing application maintenance, enhancements, and operational support activities in a fast‑paced environment.

Annual Open Enrollment Support

• Annual Open Enrollment Support:
• Respond to client and vendor questionnaires related to open enrollment readiness.
• Attend and contribute to open enrollment planning and status meetings.
• Perform other related duties as assigned.

Requirements:

• Minimum of 5 years of hands‑on experience with 834 EDI file builds, BizTalk/Logic Apps (or equivalent tools), health insurance enrollment processes and data integration.
• Bachelor’s degree in Computer Science, Information Technology, or a related field preferred, or equivalent practical experience.
• Expert‑level experience with EDI Files in general and 834 v5010 files, in particular.
• Familiarity with BizTalk and/or Oracle integration platforms (or ability to collaborate effectively with development teams using these tools or its equivalent).
• Strong project coordination and stakeholder management skills, particularly across vendor, client, and internal technical teams.
• Strong knowledge of SDLC best practices, including coding standards, documentation, version control, testing, and deployment processes.
• Hands‑on experience with Agile and Waterfall development methodologies.
• Strong analytical skills with the ability to understand complex business requirements and translate them into robust technical solutions.
• Excellent written and verbal communication skills, with the ability to collaborate effectively across technical and business teams.
• Ability to work independently, manage multiple priorities, and adapt quickly in a high‑demand environment.
• Demonstrated attention to detail, thoroughness, and commitment to quality.
• Problem‑solving mindset for production issue resolution.
• Willingness to provide mentoring and technical leadership within the team.
• Overtime and schedule flexibility is occasionally necessary in this position. The individual may be required to perform certain business‑critical job functions outside of normal working hours.