EDI Product Advisor, EDI Gateway - Evernorth
EDI Product Advisor, EDI Gateway - Evernorth
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USD 5 - 10
1 Vacancy
Job Description
Candidates who reside within 50 miles of the following locations may be asked to work in person on a hybrid schedule (three days per week): Bloomfield CT Chattanooga TN Denver CO St Louis MO or Scottsdale AZ.
Summary:
This position is responsible for driving Cigna initiatives through the development of and using industry standard formats including the suite of HIPAA EDI transactions and custom API solutions from a business perspective partnering with IT for technical components. Primary responsibilities include participation in industry workgroups and conferences focused on the development of industry standards taking a leadership role within an industry group translating the technical standards into business friendly terminology and guiding subject matter experts in how to apply standards to enterprise initiatives.
This role reports to the Provider EDI Gateway Director and is responsible for electronic gateway initiatives. The EDI transactions included in solutions work by this role include Provider Client and Clinical related and cover all Cigna and Evernorth lines of business.
Responsibilities:
- Participate in or lead industry groups and discussions to monitor industry changes and drive for industry changes that align with Cigna goals.
- Develop working relationships with individuals in similar roles at other payers provider and vendor organizations that you can collaborate with on industry standards questions.
- Read understand and provide recommendation for changes on industry technical guides.
- Provide awareness on Industry Initiatives to key matrix partners and obtain input on how those initiatives align with enterprise strategies and priorities
- Develop and maintain awareness of industry trends and gather industry expert opinion and quantitative market data for different market segments
- Work collaboratively with internal cross enterprise stakeholders to communicate information with external industry groups
- Maneuver through and transition from strategic organization view to complex process policy people and technology impacts
- Anticipate the needs of the healthcare industry 5-10 years in the future for industry standards development
- Understand and translate technical standards and requirements to be applied toward business scenarios and needs
- Assess a proposed mandate and provide feedback as to the impacts it has on Cigna and the provider.
- Consult with internal subject matter experts on industry initiatives current mandates and future mandates to assess gaps between current enterprise processes and the standard and technical guide requirements.
- Provide guidance and direction to internal partners on the application of the technical guides to solve specific business needs
Qualifications:
- Bachelors degree or higher strongly preferred or equivalent work experience required
- 3 years of EDI experience required
- 7 years working in the healthcare industry is required
- EDI transactions experience or working knowledge of EDI systems highly preferred
- Agile experience preferred
- Demonstrated understanding of healthcare and provider office workflows specifically practice management and electronic health records is required. Basic understanding of healthcare EDI transactions is highly preferred
- Able to collaborate with others in the industry on the development of new standards
- Computer skills required: MS Office (Outlook Excel Word PowerPoint Access)
- Demonstrated problem solving skills including the ability to systematically analyze complex problems
- Ability to multi-task shifting effectively among multiple activities
- Strong presentation skills
- Excellent organizational skills including proven ability to utilize resources prioritize manage and meet multiple deadlines in a highly matrixed environment
- Proven ability to listen understand and interpret information from others
- Strong written and verbal communication skills; ability to speak clearly and concisely conveying information in a manner that others can understand and interpret information from others
- Flexibility to change course based on business needs; effectively manage and deal with change
- Up to 25% travel
ORGANIZATIONAL COMPETENCIES
- Customer Focus- Is dedicated to meeting the expectations and requirements of internal and external customers; Gets first-hand customer information and uses it for improvements in products and services; Acts with customers in mind; Establishes and maintains effective relationships with customers and gains their trust and respect.
- Dealing with Ambiguity- Can effectively cope with change; Can shift gears comfortably; Can decide and act without having the total picture; Doesnt have to finish things before moving on; Can comfortably handle risk and uncertainty; Isnt upset when things are up in the air.
- Problem Solving- Uses rigorous logic and methods to solve difficult problems with effective solutions; Probes all fruitful sources for answers; Can see hidden problems; Looks beyond the obvious and doesnt stop at the first answers; is excellent at honest analysis.
- Interpersonal Savvy- Relates well to all kinds of peopleup down and sideways inside and outside the organization; Builds appropriate rapport; Builds constructive and effective relationships; Uses diplomacy and tact; Can diffuse even high-tension situations comfortably.
- Learning and Applying Quickly- Learns quickly when facing new problems; A relentless and versatile learner; Open to change; Analyzes both successes and failures for clues to improvement; Experiments and will try anything to find solutions; Enjoys the challenge of unfamiliar tasks; Quickly grasps the essence and the underlying structure of anything.
- Organizational Agility- Knowledgeable about how the organization works; Knows how to get things done both through formal channels and the informal network; Understands the origin and reasoning behind key policies practices and procedures; Understands the culture of the organization.
- Perseverance- Pursues everything with energy drive and a need to finish; Seldom gives up before finishing especially in the face of resistance or setbacks.
If you will be working at home occasionally or permanently the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position we anticipate offering an annual salary of 96800 - 161400 USD / yearly depending on relevant factors including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy balanced and feel secure. Thats why youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll be offered several health-related benefits including medical vision dental and well-being and behavioral health programs. We also offer 401(k) with company match company paid life insurance tuition reimbursement a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs visit Life at Cigna Group.
About The Cigna Group
Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race color age disability sex childbirth (including pregnancy) or related medical conditions including but not limited to lactation sexual orientation gender identity or expression veteran or military status religion national origin ancestry marital or familial status genetic information status with regard to public assistance citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama Alaska Arizona Arkansas Delaware Florida Georgia Hawaii Idaho Iowa Kansas Maryland Massachusetts Michigan Nebraska Ohio Pennsylvania Texas Utah Vermont and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
