Compensation Overview

Position Summary:

Creates implementation strategies to align with and achieve stakeholder goals. Works closely with Healthcare Payers and Networks to understand their operational and technical integration requirements. Defines Healthcare EDI-related requirements for payer-to-network integrations, and eventually for building integrations on the MacroHealth 2.0 Platform. Functions as a subject matter expert for enterprise healthcare EDI technology. Supports and educates team members across the organization. Builds and continuously optimizes implementation processes and procedures. Demonstrates teamwork and contributes to a positive work culture.

Key Relationships:

• Healthcare Payers technical and operational resources
• Network technical resources
• MacroHealth Engineering resources
• MacroHealth Product Managers
• MacroHealth Data Analytics team members
• MacroHealth Customer Success Managers

Key Accountabilities:

Creates implementation strategies to align with and achieve stakeholder goals

• Collaborates with internal and external stakeholders to deliver integration objectives;
• Defines and implements implementation strategies consistent with stakeholder goals;
• Provides subject matter expertise to EDI Solution Architects as they design and build integration solutions

Works closely with Healthcare Payers and Networks to understand integration requirements

• Works closely with Healthcare Payers and Networks to understand their operational and technical integration requirements in order to define requirements and design integration solutions.

Creates documentation and processes to ensure delivery of high quality integrations

• Creates data exchange specifications and requirements to support healthcare data integrations;
• Works closely with engineers to provide clear requirements for building customer integrations;
• Produces documentation to achieve high quality integrations;
• Builds and tests customer integrations and documentation;
• Assists with internal testing and works closely with customers during UAT phase of implementation projects.
• Reviews implementation integration solutions for completeness and fulfilment of all requirements

Acts as a SME for EDI and Industry Knowledge

• As a SME, provides EDI and industry knowledge-sharing across all MacroHealth’s teams;
• Maintains a deep understanding of MacroHealth’s platform product capabilities;
• Work closely with Product Management to provide input and feedback on platform features and functionality to support building customer integrations;
• Participates actively in Scrum related activities, including sprint planning and grooming.

Builds and continuously optimizes implementation processes and procedures

• Proactively works to identify new features required to optimize integrations;
• Builds and continuously optimizes implementation processes and procedures.

Demonstrates team-work and contributes to a positive work culture

• Recognized as a leader in area of specialty;
• Collaborates with team to achieve organizational goals;
• Contributes to development of a positive work culture by demonstrating teamwork and alignment with core company values;
• Constructively escalates problems and issues;
• Actively collaborates with other departments and teams.

Knowledge, Skills and Abilities:

• Self-starter with the ability to take ownership, work with tight timelines, and handle various tasks simultaneously;
• Strongly motivated to give exceptional customer service and ensure a positive client experience;
• Expert understanding of HIPAA transaction sets like 837,834, 835, 278;
• Hands-on experience with HIPAA logical mapping and system implementation;
• General knowledge of healthcare operations, payer business processes and provider and EDI infrastructures;
• Experience with building cloud services or SaaS technologies.
• Strong knowledge of and aptitude for cloud computing principles;
• Ability to develop strong working relationship with engineering and stakeholder groups;
• Curiosity and skill to dig deeper into requirements and the "why" with limited guidance;
• Excellent oral, written documentation, and presentation abilities;
• Demonstrated ability to contribute to the creation of a positive work culture;

Required Education and Experience:

• BS in Computer Science/Information Systems or equivalent experience;
• 7+ years’ experience as a software Systems Analyst or Business Analyst, gathering/documenting business requirements and translating into technical specifications;
• 7+ years’ experience working in a US Healthcare Payer environment;
• 5+ years’ experience in an external, client facing role.

Preferred education and experience:

• MS in Computer Science/Information Systems
• Claims, enrollment, and pricing configuration experience
• EDI QA experience

Location: fully remote within the US

Core Competencies: 

One Team:

Act as one team with fellow MacroMates and customers

Value humility, low ego, and collaboration

Maintain an All for One, One for All attitude

Deliver on Promises:

Do the right thing

Do what you say you will do

Work with a sense of urgency and transparency

Macro Thinking:

Challenge yourself and others to think boldly, bigger, and into the future

Lead with a Growth Mindset

Act as a thought leader for the healthcare industry

MacroHealth is an equal opportunity employer.