We are currently looking for a Technical EDI SME for a 100% remote position supporting a large federal government healthcare modernization project. This role will support the Department of Veterans Affairs (VA) by integrating the Fraud Waste and Abuse (FWA) tool with Community Care Development, Security, and Operations (CCDSO) products and other VA healthcare systems, including CCRS. The Technical EDI SME will assess system readiness, analyze healthcare transaction workflows, and define and implement integration strategies using ANSI X12 and other EDI-based data exchanges. This role operates within a collaborative Agile DevSecOps environment, working with business stakeholders, architects, developers, testing teams, external trading partners, and VA leadership to support reliable, secure, and compliant healthcare data exchange. The candidate must reside within the continental US.
Responsibilities:
- Assess internal and external system readiness, analyze healthcare claims workflows, and define integration strategies connecting the VA FWA tool with CCDSO products, CCRS, and other VA healthcare systems.
- Build, configure, maintain, and enhance EDI maps, workflows, and integrations for transaction sets including 835, 837, and 277CA using mapping tools, translation software, and integration platforms.
- Implement trading partner setups, communication protocols, and document formats, coordinating with external partners to validate connectivity, transaction formats, and compliance.
- Monitor daily EDI operations, troubleshoot production integration failures, perform root-cause analysis, and provide timely technical support to resolve data discrepancies and minimize business disruption.
- Collaborate with business analysts, architects, developers, QA teams, and stakeholders on requirements gathering, solution design, testing, and production implementation, while maintaining documentation for EDI processes, trading partner requirements, and system configurations.
- Validate transaction data, implement error handling and quality checks, and support audits and compliance reviews to ensure data integrity and adherence to applicable HIPAA, ANSI X12, EDIFACT, and organizational requirements.
- Take on additional tasks