Job Description

Posted Date: 3/30/2019

Position Purpose: This position is responsible for designing, developing, and supporting applications and interface solutions that facilitate and support operations (monitor quality and utilization), regulatory deliverables, and other internal purposes.

  • Review, analyze, define, and document customer and business requirements
  • Develop and communicate system documentation and testing scenarios
  • Troubleshoot, test and coordinate to resolve reported software and/or data issues while providing status to affected teams
  • Perform testing in development and production (post deployment) environments of new and existing solutions or configuration updates to ensure the final products meet or exceed business and system expectations and requirements
  • Create test plans, which describe procedures and test case scenarios to demonstrate that all business requirements have been considered and met
  • Participate in business requirements meetings to gather and record business requirements. Help to define functional requirements needed for internally-developed solutions
  • Research and resolve production issues as necessary

Education / Experience / Other Requirements


  • Associates or Bachelor’s degree in computer science related field, or equivalent experience in related roles

Years of Experience:

  • Experience using T-SQL (SPROCS, Functions, etc.) a plus
  • Experience using Visual Studio .NET/C# solutions including, Business Intelligence projects (SSRS, SSIS, etc. - BIDS, SSDT, etc.)
  • Experience supporting QNXT customizations and interfaces a plus
  • Experience supporting Microsoft BizTalk configurations, orchestrations, and packages a plus
  • Experience with Team Foundation Server and GIT a plus
  • Experience supporting Cognizant AutoQ, CMU, Claims Workflow customizations a plus
  • Experience supporting Vistar eVips a plus
  • Experience supporting ClaimsXten™, ClaimCheck, Micro-Dyn, OnBase, Optum Claims Editing, Cotiviti's (Vistar) Claim Editing a plus
  • Experience with Visio a plus

Specialized Knowledge:

  • Design develop, and deploy software solutions that address the needs of stakeholders and are consistent with HIPAA, industry, state and federal standards
  • Analyze and verify customer requirements for completeness, consistency, comprehensibility, feasibility, and conformity to standards
  • Utilize various technologies (MS BizTalk, MS SSIS, EdiDev, etc.) that support the development and maintenance of ETL solutions, which exchange data with external trading partners (Vendors, providers, and health care regulators, etc.) using a variety of proprietary and standardized interchange formats (ANSI X.12 EDI 837i,p,d, 834, 835, 278, 270/271, JSOM, XML, CSV/Pipe, Tab, etc.)
  • Utilize Microsoft web based development technologies including ASP.NET (MVC 5/6 and/or Web Forms, C#/.NET Framework 4.52/4.6, AJAX, HTML 5/6, CSS3, JavaScript, JQuery 3, Bootstrap) to create integrated enterprise managed care applications and solutions
  • Analyze and verify customer requirements for completeness, consistency, comprehensibility, feasibility, and conformity to standards
  • Query data from SQL Server 2008 R2-2017 Enterprise databases
  • Develop complex stored procedures, functions, dynamic SQL, CTEs, triggers, etc. in SQL Server T-SQL
  • Utilize MS Visual Studio and TFS in an agile team oriented development environment
  • Experienced with ETL best practices and technologies including Microsoft SQL Server Integration Services (SSIS)/Microsoft Data Transformation Services (DTS)
  • Knowledge of advanced relational database design concepts
  • Create ERDs, data dictionaries, process models, specifications, diagrams, and charts
  • Familiar with query tuning and with evaluating and configuring other DB performance tuning techniques through the use of Indexes, staged data, and other optimization methods
  • Design and maintain SSRS and/or Crystal Reports a plus
  • Work collaboratively with business customers and project teams
  • Manage time effectively to handle multiple critical level requests
  • Adaptable to dynamic environment
  • Work cooperatively, positively, and collaboratively in an interdisciplinary team
  • Ability to produce under stressful situations
  • Ability to manage multiple tasks and prioritize work to adhere to deadlines and within identified time frames
  • Experienced and familiar with managed health care systems, processes, procedures, practices and measures (ex. member enrollments, services provided to members, member demographics, claims/encounters, prior authorizations, quality, clinical, crisis, utilization metrics and meta data, etc.)
  • Familiar with ITIL Service Delivery and Lean Six Sigma best practices

Application Instructions

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