Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.

JOB SUMMARY

Join the Payer Health Plan Customer Support team as a Sr Systems Analyst working with enterprise customers of Veradigm Comprehensive Submissions Encounter Management Platform, proactively assisting them with post- sales installation, configuration, upgrade, troubleshooting and day to day operational management.
Responsibilities include taking a proactive leadership role working with the engineering team and customers to triage and resolve highly complex, technical, and application-related issues which impact product performance in customer-specific environments, or issues that directly hamper a broader customer adoption of Veradigm Comprehensive Submissions Encounter Management Platform. In addition to working with customers, the analyst will routinely partner with our development, engineering and sales engineering organizations to resolve support issues, document bugs, provide UAT on product builds, and ensure that new and newly upgraded server installations are successful.

ACADEMIC AND PROFESSIONAL QUALIFICATIONS:

• Bachelor’s Degree in Health IT/Informatics/Management Information Systems or related field required

EXPERIENCE:

• 5+ years of professional experience in Risk Adjustment data management
• Understanding of claims data, encounter response files, 837 EDI encounter files, EDGE/MA billing & business rules as well as MA filtering logic for EDPS
• Experience with CMS Submissions Process and EDI transactions
• Excellent time management and organizational skills necessary
• Prior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions.
• Experience with managing product back end and webservices
• Ability to guide customers remotely through complex, multi-server deployments and upgrades for enterprise products
• Familiarity with at least one non-Windows operating system (such as Linux, HPUX, AIX)
• Familiarity with EDI Standards such as X12, EDIFACT, HL7, NCPDP and knowledge of HIPAA transactions.
• Knowledge of various network and internet technologies and communication protocols: TCP/IP, SFTP, HTTP, AS2, etc. highly desired.
• Prior knowledge of 837’s along with various loops and segments and an understanding of the requirements set forth by CMS for EDPS submission files
• Prior experience with ETL and Mapping
• Excellent working knowledge of SQL
• Very strong written and verbal skills.
• Knowledge in CMS model changes is a plus
• Knowledge of CMS Risk Score and Risk Adjustment methodologies is a plus.
• Knowledge of Medicaid is a plus and having a good understanding and work experience on the Medicaid is a great added value.

TRAVEL REQUIREMENTS:

• Will travel to Company head quarter for new hire orientation and if there are any specific training or customer meetings.