Sr Implementation Consultant

Cotiviti; United States; Remote; USD 100,000 - 145,000; Full time

Job summary

Cotiviti is seeking an Senior Implementation Consultant to test, implement and integrate Edifecs solutions for payer clients. You will install and configure software on client environments, develop mappings, and ensure interoperability across EDI, FHIR, HL7, and REST/SOAP services.

You will collaborate with analysts, architects and delivery leads, support QA in SIT/UAT, and provide end-user training and post-implementation support. Strong healthcare data domain expertise is required.

Qualifications

• Bachelor’s or higher in computer science or related field with experience implementing Java enterprise apps.
• 5+ years of technical healthcare system implementation experience, preferably with payer/health plan.
• 3+ years of experience with EDI mapping and analysis.
• Deep understanding of X12, FHIR and other standards-based interoperability in healthcare.
• Experience with JSON/XML/HL7v2/CVS/pipe-delimited data formats.
• Proficiency with Edifecs applications and related tooling.
• Experience with AWS/Azure CI/CD pipelines and Agile/SAFe environments.
• Strong SQL knowledge (SQL Server, Oracle) and data modeling.

Responsibilities

• Install and configure Edifecs solutions on client environments (cloud or on-prem).
• Integrate Edifecs products with customer systems and troubleshoot interfaces.
• Translate business requirements into technical configurations and workflows.
• Develop and test real-time and batch integrations (EDI, HL7, FHIR).
• Create mapping specifications and perform data validation and reconciliation.
• Support ETL processes and data migrations to new payer systems.
• Assist QA with test cases and SIT/UAT validation.
• Provide post-implementation support and training materials.

Skills

EDI mapping

X12 standards

FHIR

HL7

AWS/Azure

CI/CD pipelines

REST & SOAP

Java

SQL databases

Healthcare data domains

Education

Bachelor's degree in CS/IT

Tools

Mirth Connect

InterSystems

Talend

AWS Glue

Job description

Overview

The Senior Implementation Consultant assists in the testing and implementation of Edifecs’ solutions purchased by that client. The Implementation Consultant will generally be involved in installing & configuring under the direction of the Technical Project Manager and/or Implementation/Solution Architect. This includes installation of products on client hardware; configuration and development of programs, tasks and guidelines, and setup to fully implement an Edifecs solution. Duties can range from delivery of product training to new client specific requirements, development and deployment. The role involves client coordination and communication as well as technical understanding of Edifecs’ solutions and the transactions that flow through this position.

Responsibilities

• Implement and configure Edifecs applications for payer systems on AWS, Azure cloud or virtual machines.
• Implement and manage integrations between Edifecs’ products and solutions and Customer’s on-premise systems.
• Analyze business requirements and translate them into technical configurations, workflows, and mapping documents.
• Develop and test real-time and batch integrations using:
  • EDI (X12: 834, 837, 835, 270/271, 276/277, 278)
  • FHIR (CMS Interoperability APIs)
  • HL7 v2/v3
• Implement service-based integrations via RESTful APIs, SOAP Web Services, ESBs, and iPaaS platforms.
• Create mapping specifications and perform data validation, reconciliation, and error resolution.
• Support ETL processes and legacy data migration to new payer systems.
• Perform data profiling, cleansing, transformation, and loading activities.
• Assist QA teams with creating technical test cases and validating system configurations and interfaces during SIT/UAT.
• Partner with business analysts, SMEs, solution architects and delivery leads to ensure alignment of technical deliverables.
• Develop appropriate training and development plans to meet the client’s particular maintenance level and to configure the software according to the project plan.
• Provide post-implementation support during the transition from implementation to maintenance.
• Provide software and client specific training and develop training documentation based on present standards and client needs.
• Participate in design workshops, integration sessions, and go-live readiness planning.
• Provide technical guidance to junior implementation staff and contribute to solution documentation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications

• Bachelor’s in computer science, Information Technology, Information Systems or other technology related degree or equivalent experience in implementing, and operating Java stack-based enterprise applications.
• 5+ years of experience in technical healthcare system implementation, preferably with a payer or health plan.
• 3+ years of experience with Electronic Data Interchange (EDI) mapping and EDI analysis.
• Deep understanding of X12 standards, FHIR and other standards based interoperability / integration patterns in the Healthcare Industry.
• Hands on experience in analyzing transactions and creating interfaces for transactions such as X12 837, 835, 834, proprietary formats and deep knowledge of coding standards such as LOINC, SNOMED, ICD 10.
• Familiarity with data formats: JSON, XML, HL7v2 messages, X12, flat files (CSV, pipe-delimited, etc.).
• Strong knowledge of Edifecs Applications.
• Decent knowledge of healthcare EDI transactions (834, 837, 835, 270/271, 278).
• Proficiency in data modeling (logical & physical) and relational databases (SQL Server, Oracle)
• Experience implementing solutions on AWS, Azure using CI/CD pipelines (GitLab, Jenkins, Terraform, CloudFormation).Experience working in Agile or SAFe environments.
• Working knowledge of java programming language and good understanding of SOAP and REST based webservices.
• Prior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions.
• Prior experience in troubleshooting problems in java based applications using opensource tools / JDK tools such as jstack, visualvm, jconsole, jmap and similar tools to identify memory issues, deadlocks, application performance.
• Experience using integration engines or tools (e.g., Mirth Connect, InterSystems, AWS Glue, Talend) is a plus.
• Expertise with healthcare data domains: member, claims, provider, enrollment, and clinical data.

Cognitive / Mental Requirements:

• Ability to work independently as well as collaborate as a team with a sense of urgency.
• Professional with the ability to properly handle confidential information.
• Be value-driven, understand that success is based on the impact of your work rather than its complexity or the level of effort.
• Ability to handle multiple tasks, prioritize, and meet deadlines.

Physical Requirements and Working Conditions:

• Flexibility to work with global teams as well as geographically dispersed US-based teams.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Base compensation ranges from $100,000 to $145,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.