Senior Systems Analyst
Baltimore, MD, US • Posted 4 hours ago • Updated 4 hours ago

Triwave Solutions Inc
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Job Details
Skills
- Master Data Management
- Enterprise Application Integration
- Evaluation
- Health Care
- MPI
- Conflict Resolution
- Data Analysis
- Database
- Edifecs
- Electronic Data Interchange
- ASC X12
- Affordable Care Act
- Analytical Skill
- AutoCAD Architecture
- Request For Proposal
- Root Cause Analysis
- SOA
- SQL
- Medicaid
- Microsoft Exchange
- Mobile Device Management
- ROOT
- Scripting
- Technology Assessment
- Testing
- WTX
- Writing
Summary
Analyst, Systems (Senior) Provide data analysis, transactional support, error detection, resolution, and all related services for the successful Electronic Data Interchange (EDI) Operations of the Exchange. Perform 8001 Medicaid transaction file analysis and validations. Review and resolve all data issues, including but not limited to Master Data Management (MDM), Master Person Identifier (MPI), and other data issues. Perform HBX System Error analysis. Validate 1095-A and 1095-B files, and reconcile 8001 transactions. Analyze EDI files sent to and received from Carriers, Managed Care Organizations (MCO), and other entities, and identify errors and root causes for EDI file rejections. Coordinate with the development team, business team, and testing team to analyze, fix, test, and transmit EDI files daily and as required. Analyze the EDI 999 files from the Carriers and MCOs and perform root cause analysis for exceptions, and assist with resolving any data issues. Perform data changes to fix consumer or system-reported errors, coordinate with technical and business teams to analyze error reports, access the HBX databases and applications to perform root cause analysis for transaction rejections, and provide data fixes and technical solutions. Communicate with the IT team, business team, vendor teams, and other stakeholders to translate business needs into EDI data fixes and solutions. Note: The candidate must have the flexibility to work overtime, as needed, including weekends, holidays, and off-hours.
2.6 Personnel Qualifications - Minimum Qualifications
For minimum qualifications, see the labor category description in MHBE IT IDIQ RFP for the subject RFR labor
category. In addition, qualified candidates MUST meet the minimum qualifications specified below. Please refer
to RFP Section 2.6.1 minimum qualifications for substitution requirements.
Candidates not meeting minimum qualifications will be deemed not reasonably susceptible for the award and
will not progress to full evaluation.
Labor Category/s
(From Section 1 Above) Minimum Qualifications
Analyst, Systems (Senior) A minimum of four (4) years of experience with the Health Exchange marketplace EDI solutions. A minimum of four (4) years of experience creating EDI X12 files for transaction sets such as 834, 999, and TA1. A minimum of four (4) years of experience in reviewing and understanding technical documents such as companion and implementation guides for Healthcare EDI formats 834 and 999. A minimum of four (4) years of experience in analyzing, testing, and providing data solutions for healthcare marketplaces. A minimum of two (2) years of experience working with SQL databases/queries. Strong analytical and problem-solving skills.
Excellent communication skills, including the ability to understand and communicate technical information to business users and gather business requirements that can be translated into technical requirements. Ability to manage multiple critical priorities and tight deadlines.
Preferred Qualifications
The additional Experience/Knowledge/Skills listed below are preferred by MHBE.
Analyst, Systems (Senior) A minimum of six (6) years of experience with EDI validation tools such as Edifecs, WTX, EDI X12 files, or equivalent. A minimum of six (6) years of experience with EDI transaction sets such as 834, 820, 999, and TA1, SOA, EDI, or EAI applications. A minimum of two (2) years of hands-on experience writing complex SQL scripts. Knowledge of the Affordable Care Act (ACA) eligibility rules for Medicaid and Qualified Health Plans. Experience with or knowledge of Medicaid 8001 file processing or any other inter-agency transactional file processing. In-depth understanding of EDI 834 enrollment transactions, including Adds, Changes, Terminations, Cancellations, and error processing.
- Dice Id: 91125814
- Position Id: 8875419
- Posted 4 hours ago
Company Info
Garnering Accolades for Health and Human Services in Maryland
Based in Columbia, Maryland, Triwave is a Certified Small Business as designated by the Federal government, demonstrating its commitment to contributing to the community and promoting the safety, security, and well-being of citizens. Triwave specializes in innovative services and solutions utilizing cloud, analytics, artificial intelligence, and data management that enhance governance while reducing costs for state and local agencies such as the Department of Human Services (DHS) at Maryland and Department of Child Services (DCS) at Indiana. Triwave recently delivered agency-wide modernization programs for the State of Maryland as a Master Contractor that transformed the technology landscape and garnered award and recognition for the team. Triwave has also received the prestigious honor of being named a top IT Consulting Firm for the years 2022 and 2023.
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