We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.
Your role involves coordinating implementation of 834, 837, and other proprietary eligibility and claims EDI processes, COB and group files for various health plans ensuring success configuring EDI processes, aligning data operations with key business priorities and deliverables. This role is technical, requiring an understanding of EDI processes, including eligibility, claims, and accumulators among others. You will work closely with Account Managers, Implementation Managers, clients, and their benefits partners, as well as the internal Data Operations teams responsible for execution
In this role you will wear many hats, but your knowledge will be essential in the following:
- Essential Functions/Responsibilities/Duties
- Operational Leadership: Manage end-to-end project delivery for data operations teams, including requirements gathering, file specification development, execution, and monitoring.
- EDI Configuration Requirements: Work closely with internal and external partners, along with healthcare providers and payors to ensure all Inbound and Outbound EDI connections are setup properly, including coordinating resolution of any issues
- Change Management: Facilitate smooth transitions for changes to a client’s benefits
- Stakeholder Engagement: Collaborate with business leaders, data scientists, engineers, and other stakeholders to define project scope, objectives, and success criteria.
- Risk Management: Identify and mitigate project risks, ensuring timely resolution.
- Quality Assurance: Maintain high standards for data accuracy, consistency, and reliability.
- Reporting and Metrics: Provide regular updates on project status, milestones, and KPIs.
- Process Improvement: Continuously enhance data-related processes and workflows.
- Vendor Management: Coordinate with external vendors and partners as needed.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Qualifications:
In order to represent the best of wha
- Completed a B.S./M.S. in Healthcare Administration, Project Management or relevant equivalent
- 5-9 years’ experience as an Implementation Manager, Engineer, EDI Specialist, Business Analyst or other related Medical Insurance Analyst roles
You also take pride in offering the following Core Skills, Competencies, and Characteristics:
- The position requires the ability to coordinate and facilitate integration discussions with third parties, develop and maintain documentation, coordinate extensive testing with multiple parties and perform impact assessments
- Manage deliverables in JIRA, Confluence, and relevant tools
- Enjoy learning about new technologies and how they can be practically applied
- Determine and document EDI requirements, and confirm these meet customer needs by reviewing with internal and external stakeholders.
Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.
We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.