PROGRAMMER/ANALYST 4 - 08112026- 79534

State of Tennessee

Nashville (TN)

Hybrid

USD 66,000 - 90,000

Full time

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Job summary

State of Tennessee’s TennCare division seeks a Programmer/Analyst 4 (EDI SME) to lead architecture and data exchange efforts for ASC X12 and NCPDP transactions. The role emphasizes technical leadership, complex mapping, and collaboration with partners in a hybrid work setting in Nashville, TN.

The ideal candidate has a bachelor’s degree and 3 years of relevant experience in software development, databases, or information systems, with substitution options for education, and the ability to guide

Qualifications

Bachelor's degree and 3 years of professional experience in software development, database design, systems analysis or information systems instruction.
Substitution of experience for education may occur year-for-year up to four years.
One year of experience as Programmer/Analyst 3 with the State of Tennessee.

Responsibilities

Serve as SME for architecture, analysis, and support of healthcare data transactions (ASC X12 and NCPDP).
Design, test, and troubleshoot mapping, translation, and routing of EDI files.
Draft, review, and maintain technical documentation including guides and diagrams.
Perform advanced root-cause analysis on translation or mapping failures and data anomalies.
Collaborate with vendors and trading partners to ensure regulatory compliance.
Provide guidance to PA 3 analysts and establish best practices.

Skills

Active Learning and Listening

Operations Analysis

Judgment and Decision Making

Technology Design

Systems Analysis

Tech Savvy

Manages Complexity

Communicates Effectively

Self-Development

Education

Bachelor's degree in Computer Science / Information Systems / related field

Tools

Personal Computer

Telephone

Printer/Copier/Fax Machine

Bar Code Scanner

Mobile Devices

Job description

State of Tennessee Job Information
Opening Date/Time 08/11/2026 12:00AM Central Time

Job Information

State of Tennessee Job Information

Opening Date/Time 08/11/2026 12:00AM Central Time

Closing Date/Time 08/24/2026 11:59PM Central Time

Salary (Monthly) $6,544.00

Salary (Annually) $78,528.00

Job Type Full-Time

City, State Location Nashville, TN

Department TennCare

LOCATION OF (1) POSITION(S) TO BE FILLED: DIVISION OF TENNCARE, DAVIDSON COUNTY

The Division of TennCare is dedicated to providing our employees with a hybrid work environment. All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need. You may review the specific expectations with our hiring team.

This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Qualifications
Education and Experience: Graduation from an accredited college or university with a bachelor\'s degree AND three years of professional experience in one or a combination of the following: (1) software development; (2) database design; (3) systems analysis or design; or (4) information systems instruction.

Substitution of Experience for Education: Additional professional level experience in software development, database design, systems analysis or design, or information systems instruction may substitute for the required degree on a year-for-year basis to a maximum of four years (e.g., one year of experience in the above areas is equivalent to forty-five quarter hours of coursework).

Substitution of Specific Associate\'s Degree for the Required Bachelor\'s Degree: Graduation from an accredited college or university with an associate\'s degree in computer engineering, computer and information science, computer hardware networking, management information systems, or software development may substitute for the required bachelor\'s degree.

OR

One year of experience as a Programmer/Analyst 3 with the State of Tennessee.

Overview
The Programmer/Analyst 4 (EDI SME) serves within the Information Systems division at TennCare. This role functions as Subject Matter Expert for healthcare Electronic Data Interchange (EDI) systems, architecture, and compliance. The individual will report directly to the Programmer/Analyst Supervisor and will have no direct reports, functioning primarily as an advanced individual contributor and technical lead. This position is critical to maintaining the integrity of data exchange between the agency, managed care organizations (MCOs), and other trading partners, ensuring seamless processing of ASC X12 and NCPDP transactions.

Responsibilities

Serve as a technical Subject Matter Expert (SME) for the architecture, analysis, and support of healthcare data transactions, specifically ASC X12 (including 837, 835, 820, and 270/271) and NCPDP post-adjudication standards (PAS 4.5 and PAS 53).
Design, test, and troubleshoot complex mapping, translation, and routing processes for inbound and outbound EDI files.
Draft, review, and maintain comprehensive technical documentation, including EDI companion guides, continuity plans, implementation specifications, and system architecture diagrams.
Perform advanced root-cause analysis on translation or mapping failures, data extract anomalies, and integration issues, implementing robust solutions.
Collaborate with vendors, trading partners, and other TennCare business units to ensure strict compliance with state and federal healthcare EDI regulations.
Identify formatting issues within transaction elements or loops (e.g., identifying incorrect segment or element usage) and work with stakeholders to correct data submissions.
Provide technical guidance to P/A 3 analysts, establishing best practices for data analysis, document reviews, and daily tasks.

Competencies (KSA\'s)

Competencies