Senior Systems Analyst EDI (Health Exchange / Medicaid)

Position: Senior Systems Analyst EDI (Health Exchange / Medicaid)
Client: Maryland Health Benefit Exchange (MHBE)
Location: Baltimore, MD (Hybrid)
Primary site: 750 E. Pratt Street, 6th Floor, Baltimore, MD
(On-site or remote work required on specific days as determined by MHBE)

Start Date: March 2, 2026
Duration: Initial term through June 30, 2026, with two potential one-year extensions through June 30, 2028
Engagement Type: Contract

Project Overview

MHBE operates Maryland Health Connection, the state s health insurance marketplace supporting eligibility and enrollment for Qualified Health Plans, Medicaid, and MCHP. The role focuses on EDI operations supporting healthcare enrollment, Medicaid transactions, and carrier integrations.

Key Responsibilities

• EDI data analysis, transaction support, error detection, and resolution
• Medicaid 8001 transaction file analysis and validation
• Analyze and reconcile EDI X12 files (834, 999, TA1, 820)
• Review and resolve MDM/MPI issues
• HBX system error analysis and root-cause investigation
• Validate 1095-A and 1095-B files
• Review EDI 999 acknowledgements and resolve exceptions
• Coordinate with development, testing, and business teams
• Perform data fixes in HBX systems/databases
• Translate business requirements into technical EDI solutions
• Support production operations (including off-hours as needed)

Required Qualifications

• 4+ years of experience with Health Exchange marketplace EDI solutions
• 4+ years working with EDI X12 files (834, 999, TA1)
• 4+ years reviewing EDI companion and implementation guides
• 4+ years delivering data solutions for healthcare marketplaces
• 2+ years of SQL query experience
• Strong analytical, communication, and multitasking skills

Preferred Qualifications

• 6+ years using EDI validation tools (Edifecs, WTX, or similar)
• 6+ years supporting EDI transaction sets (834, 820, 999, TA1)
• Experience with SOA, EDI, or EAI applications
• Advanced SQL scripting
• Knowledge of ACA eligibility rules (Medicaid & QHP)
• Experience with Medicaid 8001 files
• Deep understanding of the EDI 834 enrollment lifecycle (adds, changes, terminations, cancellations, errors)