Vendor and EDI Integrations

The Vendor & EDI Integration is responsible for overseeing CorVel’s external data‑exchange ecosystem, including vendor integrations, clearinghouse partnerships, EDI/API connectivity, and Hub data services. This role drives the strategy, governance, and operational execution of all third‑party “bridges,” ensuring high‑quality, compliant, and scalable data exchange in support of bill review, provider networks, and enterprise operations.

The position partners closely with IT Development, Product, Operations, and Legal to deliver reliable integrations, troubleshoot issues, accelerate onboarding, and expand CorVel’s integration capabilities.

This is a remote role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Vendor & Clearinghouse Management

• Serve as business owner for all third‑party integrations
• Lead vendor governance including SLAs, KPIs, QBRs, contract adherence, and roadmap alignment.
• Oversee clearinghouse workflows and validation processes for EDI 837, 835 acknowledgments, error notifications, and provider submissions.

EDI Strategy & Expansion

• Ensure compliance with industry standards
• Build scalable EDI ingestion, routing, validation, and audit processes across business units.

Integration Ownership

• Lead implementation and continued enhancement of the integration model (API/EDI/file ingestion, acknowledgments, routing).
• Oversee functional requirements including flexible layouts, acceptance/rejection monitoring, file acknowledgments, troubleshooting, and reporting dashboards
• Partner with development teams to design scalable schemas, table structures, and intake processes aligned to enterprise integration standards.

Integration Execution & Technical Troubleshooting

• Serve as escalation point for vendor, clearinghouse, and EDI issues, coordinating with internal and vendor technical teams.
• Maintain mapping documentation, partner-specific schemas, and integration specs.
• Support defect identification, root‑cause analysis, and remediation across all integration layers.

Client Onboarding & Implementation

• Lead client onboarding to existing bridges, ensuring consistent and scalable processes.
• Drive discovery, requirements documentation, test file validation, UAT, cutover, and production readiness.
• Maintain standardized implementation playbooks

Cross‑Functional Collaboration

• Work with IT, Operations, Product, and Legal/Compliance teams to ensure integration readiness and support ongoing enhancements.
• Communicate system updates, and partner readiness to internal stakeholders.
• Support product demos, training, and documentation for internal and external users when required.

KNOWLEDGE & SKILLS:

• Advanced understanding of EDI standards (X12), clearinghouse operations, secure file transport (SFTP/API), and data exchange frameworks.
• Strong technical troubleshooting capabilities across file, API, and EDI workflows.
• Experience with data mapping, validation rules, exception handling, and file reconciliation.
• Excellent project management, communication, and vendor negotiation skills.
• Ability to work cross‑functionally and manage multiple high‑priority initiatives simultaneously.
• Strong organizational skills and detail orientation.

EDUCATION & EXPERIENCE:

Required:

• Bachelor’s degree in Business, IT, Engineering, or related field (or equivalent experience).
• 5–8+ years of experience in vendor management, EDI operations, integration management, or technical program management.
• Proven experience with healthcare, workers’ compensation, or bill review integrations involving EDI and/or clearinghouse workflows.

Preferred:

• Familiarity with CorVel systems a plus.
• PMP, CSM, or related certification.

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range:  $87,190 - $134,613

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL: 

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.  CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-Remote