10+ years of product management or product delivery experience
Experience driving specifications, delivery, and design for utilizing EDI
Experience with managing partner relationships, particularly in the adjudication space
Familiarity with Agile software development
Requirements:
Drive strategy and development of a cross-product EDI solution focused on adjudication system partnerships to deliver an optimal experience for payers, providers, and members
Inventory current EDI/adjudication partners, assess gaps, and provide subject-matter-expertise on EDI utilization, workflows, use cases, UI design, and specifications; coordinate with shared services to align release schedules and acceptance criteria
Lead delivery of EDI initiatives and strategic partnerships by managing cross-team dependencies, defining platform requirements, and addressing customer needs with proactive solutions, including potential platform migrations and gap analyses
Create and maintain program communications and collateral—such as status reports, release notes, training guides, client and market collateral, and thought leadership content—and mentor staff while ensuring HIPAA/privacy compliance
Job description
Job Title: EDI Specialist Work Location (City/State): Remote Duration: Long term
U.S. Citizens and those authorized to work in the U.S. are encouraged to apply. We are unable to sponsor at this time.
Job Responsibilities:
Product, EDI & Adjudication Partnership Platforms role is a management role responsible for working closely across the product management, operations, and technology teams to ensure execution and delivery of initiatives focused on electronic data interchange (EDI) and partnerships with Adjudication Systems. Specifically, the Product Manager will be responsible for delivering cross-product technology solutions to enhance the service experience for stakeholders, including payers, providers, and members. The lead will own driving the strategy for and development of a division wide EDI standardization plan, building strategy around partner adjudication systems, Clearinghouse consolidation, building monitoring and measuring plans, and, critically, planning for how to use EDI and the existing and strategic partnerships as a strength.
Key Responsibilities
Drive strategy for and development of a cross-product EDI solution, especially focused on adjudication system partnerships, to drive an optimal experience for payers, providers, and members
Inventory current EDI / Adjudication partners and assess current state gaps and needs
Provides subject matter expertise in areas including EDI utilization for development, workflows, use cases, user interface design, and specifications.
Lead and drive delivery of EDI and strategic partnerships by working with shared services teams; responsibilities include identifying and managing cross-team dependencies to align on the release schedule, proactively developing solutions, delivering platform requirements and defining acceptance criteria.
Manage customer needs for platform enhancements and improvements; and proactively develops solutions to meet a diverse client base
Partner closely with operations and IT on potential platform migrations: assess business case, perform gap analysis
Prepare and communicate program level status reporting to key constituents, stakeholders, and executive team
Actively contribute new ideas and support ad hoc projects, including time-sensitive requests
Accurately scopes out projects, sets objectives and goals, develops schedules, measures performance against goals, and evaluates results
Responsible for creating and maintaining any collateral documentation such as release notes, training guides, etc.
Responsible for creating and maintaining client and market focused collateral explaining experience and use cases for outside distribution
Responsible for thought leadership market communication (e.g., articles, webinars, posts) to help sell our vision on why the integration of the member, provider, and payer is key to a well delivered overall solution
Mentor staff and team members to ensure alignment with goals
Ensure compliance with HIPAA regulations and requirements.
Maintain awareness of and ensure adherence to standards regarding privacy
Skills and Experience Required:
10+ years of product management or product delivery experience
Experience driving specifications, delivery, and design for utilizing EDI
Experience with managing partner relationships, particularly in the adjudication space
Experience with UI and UX
Familiarity with Agile software development
Background and / or understanding of the healthcare industry
