Senior Data Analyst Electronic Data Interchange

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in.

Work Culture:

GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive.  This philosophy enables us to create the health plan of the future and do our best work – Together.

GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer).

GCHP’s focuses on 5 Core Values in the workplace:

•    Integrity

•    Accountability

•    Collaboration

•    Trust 

•    Respect

Disclaimers:

•    Flexible work schedule is based on job duties, department, organization, or business need.

•    Gold Coast Health Plan will not sponsor applicants for work visas.

POSITION SUMMARY

Senior Data Analyst/EDI is responsible for managing and analyzing electronic data interchange (EDI) transactions, ensuring accurate data flow between the organization and external partners, including providers, payers, and vendors. This role involves troubleshooting, maintaining compliance with healthcare industry standards, and leveraging data insights to support decision-making and operational efficiency.

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Amount of Travel Required: 5-10%

ESSENTIAL FUNCTIONS

Job Function & Responsibilities

The following duties are expected to be performed for both the Medicare, Medicaid and any new business units:

•    Performs regular system monitoring to verify the integrity, health and availability of all systems and key processes, reviewing application and system logs and ensuring completion of scheduled jobs 

•    Responsible for ensuring that data received from external and internal parties (such as our Clients and Vendor partners) are successfully ingested and available for processing in our transactional systems, while also ensuring that file extracts for external and internal business partners are produced and delivered on the agreed upon schedule.

•    Assists in the development and optimization of file exchange process monitoring tools and processes

•    Ownership over the version of all EDI mapping documentation

•    Participates in Data Governance Council meetings

•    Oversee the integration of various data sources and ensure seamless data flow across different systems within the organization

•    Partner with Data Engineering and Data Governance on the accuracy of the data models and the outputs to optimize operational performance and achieve financial targets

•    Provide ad-hoc analysis to support L2 inquiry requests

•    Assist in managing EDI projects, system upgrades, implementations, and enhancements, ensuring successful completion within agreed timelines and budgets

•    Partners with Vendors on issue resolution

MINIMUM QUALIFICATIONS

Education & Experience: 

•    BA/BS in MIS, statistics, computer science, mathematics, information management, business, or a related field Preferred

•    4+ years of experience of performing data analysis and reporting development

•    4+ years of experience with writing SQL queries and stored procedures with relational databases

•    Experienced with supporting healthcare business transactions for Medicare and Medicaid business

•    IT Service desk experience

•    Comfortable working with large raw data files (Csv, Txt , EDI) is necessary (editing, manipulating, searching.

•    Intermediate level of proficiency in MS packages including ADO

•    Ability to plan, implement, test, and troubleshoot complex technology, software, and syst