Sr. Business Systems Analyst, UHC M&R - Horsham, PA

Unitedhealth Group Inc. Horsham , PA 19044

Posted 5 months ago

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)

Primary Responsibilities include:

  • Analyze, develop, test, and implement, business requirements and decisions using Edifecs SpecBuilder software.

  • Partner with business product owner and other appropriate team members to recognize and analyze gaps, consider solutions and deliver working software for the EDI transaction set and specifically with 837/835, 270/271, and 276/277 EDI transactions.

  • Project execution within Agile framework methodologies.

  • Ability to analyze root-cause issue, problem solve and provide key recommendations for production support and implementation of process improvements.

  • Communicate and manage potential impacts and risks associated with implementing proposed solutions to business partners and relevant Stakeholders.

  • Ability to function in a multi-project environment with changing priorities.

  • Develops innovative approaches and is sought out as an EDI expert.

Required Qualifications:

  • BA/BS degree in Computer Science, Business or related field and/or equivalent education and experience.

  • 5 years of experience working with multiple stakeholders in a matrix type environment to achieve project deliverables required

  • 4 years of experience in Healthcare EDI transactional processing (i.e.,837/835, 270/271, 276/277, 834)

  • 3 years of experience with Edifecs Specbuilder Software and various ANSI X12 transaction sets

  • Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities

Preferred Qualifications:

  • Experience with various file formats (X12, XML, CSV, Delimiter, Fixed ASCII, Database)

  • Configuration file creation within Edifecs SpecBuilder software module for standard edits as well as customized edits

  • Map creation experience for both inbound and outbound trading partner relationships within Edifecs Smart Trading software suite for various ANSI X12 transaction sets

  • Experience with Edifecs Transaction Manager for processing validation and dashboard reporting

  • Healthcare domain expertise or background working with Claims, Enrollment, and Call Center Operations teams

  • Intermediate level of proficiency with Excel, Visio, PowerPoint and SharePoint

  • Strong oral and written communications and presentation skills.

This position is as a Subject Matter Expert on the EDI transaction set with Edifecs Specbuilder software experience. The position calls for the fulfillment of business processing requirements of EDI transactions, for intake, processing and providing output to internal processes and external business partners. Excellent communication skills are required and will be used daily in collaboration with business product owners in isolating and documenting requirements.

Careers at UnitedHealthcare Medicare & Retirement.

The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Senior Business Systems Analyst, UHC M&R, Horsham, PA, Pennsylvania


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Sr. Business Systems Analyst, UHC M&R - Horsham, PA

Unitedhealth Group Inc.