EDI Technical Project Manager

Experience requirements

• Minimum ten (10) years of broad, increasingly responsible experience applying project management principles, methods, techniques, and tools.
• At least four (4) years of experience serving as a senior project manager for one or more large or complex IT projects.

Education and certifications

• Bachelor’s degree (required).
• Project Management Professional (PMP) certification from the Project Management Institute (PMI) (required).

Preferred / highly desired qualifications (EDI + healthcare)

• 10+ years of healthcare information systems project management experience, specializing in claims management, requirements gathering, and vendor selection/coordination.
• 5+ years as a Subject Matter Expert (SME) in Electronic Data Interchange (EDI) and HL7 integration, including healthcare payer/billing codes.
• Led end-to-end EDI claims migrations and trading partner transitions (e.g., payer/provider onboarding, companion guide alignment, enrollment, testing, and cutover).
• Experience modernizing claims EDI pipelines (e.g., X12 837/835/270/271/276/277/278, acknowledgements 999/277CA, 834 enrollment) across multiple lines of business.
• Managed claims platform modernization and digital transformation programs (e.g., core claims replacement, clearinghouse change, cloud migration, workflow automation) from discovery through go-live and hypercare.
• Deep expertise in EDI implementation lifecycle: requirements, mapping/specs, translation/validation rules, test strategy, end-to-end testing, defect triage, and production monitoring.
• Proven ability to coordinate cross-functional claims stakeholders (adjudication, enrollment, provider, finance, compliance, IT) and external partners (payers, TPAs, clearinghouses, vendors).
• Experience leading data conversion and reconciliation for claims migrations (e.g., historical claims, member/provider master data dependencies, balancing, and exception management).
• Proven leadership of large-scale modernization efforts (e.g., EHR conversions, data migrations).
• Strong change management capabilities, stakeholder communication, and cross-functional team leadership.
• Hands-on experience with Smartsheet for project tracking.
• Experience with Jira and agile delivery practices.
• Led full SDLC lifecycle for multiple EHR implementations (e.g., Epic, Cerner, Allscripts).

Additional domain expertise (nice to have)

• Data analysis and data analytics SME
• Data integration and interface SME
• Population Health and Public Health domain experience
• Budget tracking and forecasting
• Claims analysis and management
• Data warehouse / business intelligence (BI/BUS) exposure
• Clinical workflow design, execution, and training
• CMS Managed Care contract knowledge
• Data collection and transmission using tools such as CRM, EMR, HIE, HL7, etc.
• EMR/EHR build and implementation experience across ambulatory and acute care settings
• Experience supporting or training across multiple EMR platforms (e.g., Cerner, Epic, Allscripts, eCW, NextGen, Greenway, Medline, McKesson/GE-Centricity, Athena, Meditech)