[Hiring] Facets/EDI Developer II @PacificSource Health Plans

Role Description

Work within a team to design, develop, and maintain backend services that process complex data, including EDI X12 standards, while ensuring the integrity of data exchanges across internal and external systems. Key responsibilities include:

• Analyzing requirements and understanding business processes.
• Developing solutions that support business applications, often involving integration across various systems.
• Collaborating with cross-functional teams, including IT and business stakeholders.
• Managing time and expectations to deliver high-quality solutions that align with business goals.

Specific duties include:

• Develop, optimize, and support code solutions in languages like Python, C#, and Microsoft Transact-SQL to enhance systems managing healthcare EDI X12 transactions and related business logic. [15%]
• Design and implement solutions for processing EDI X12 files using Edifecs to parse, transform, validate, and manage EDI data, ensuring compliance with industry regulations and company policies regarding data security and privacy (e.g., HIPAA). [25%]
• Develop and maintain solutions to manage the end-to-end encounter data submission process through the Edifecs Encounter Management, ensuring data accuracy, compliance, and timely delivery to regulatory entities. [15%]
• Design and develop backend services, APIs, and stored procedures to support reliable data extraction, transformation, and updates on TriZetto Facets database, ensuring data integrity and alignment with healthcare business requirements. [20%]
• Work with the Facets Core Administration platform to support business logic related to healthcare claims processing, billing, and member data management, ensuring compliance with industry regulations. [15%]
• Design and implement comprehensive unit, integration, and system testing strategies to ensure the accuracy and functionality of EDI systems. Conduct code reviews and assist entry level developers with technical design decisions and debugging strategies. [5%]
• Diagnose and resolve complex production issues involving multiple systems or services. Complete post-incident reviews and implement preventive measures. [2%]
• Identify and implement process improvement within the EDI and Facets environments to increase automation, reduce manual intervention, and improve data accuracy. [2%]
• Stay current with new healthcare regulations and technologies related to EDI and Facets to propose enhancements and ensure ongoing compliance. [1%]

Qualifications

• Bachelor’s degree in Computer Science or a related field.
• Minimum of two (2) years’ experience, including:
• Hands-on experience in Healthcare EDI and FACETS development and analysis.
• Visual Studio.NET languages (primarily C#), object-oriented programming languages (mainly Python), and SQL/Stored Procedures.
• Edifecs Encounter Management to manage the end-to-end encounter data submission process.
• Edifecs Smart Trading Platform for handling EDI transaction flows.
• Edifecs Spec Builder for EDI data mapping and transformation based on regulatory standards (e.g., HIPAA).
• Facets Core Administration platform and TriZetto Facets database structures, particularly in member enrollment, claims processing, billing, and payment management in a healthcare setting.
• REST/SOAP APIs to support and enhance applications.
• Working with EDI communication protocols like FTP, SFTP, etc.
• Working collaboratively within a cross-functional team, contributing to both technical and business goals.

Requirements

• Employer: PacificSource
• Location: Springfield, OR
• Salary: $87,000 per year
• Hours: 40hrs/week
• Send resume and cover letter to [email protected] and refer to ID# 2026-501

Skills

• Accountability
• Collaboration
• Communication (written/verbal)
• Flexibility
• Listening (active)
• Organizational skills/Planning and Organization
• Problem Solving
• Teamwork

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

• Base Range: $64,871.24 - $110,281.11

Our Values

• We are committed to doing the right thing.
• We are one team working toward a common goal.
• We are each responsible for customer service.
• We practice open communication at all levels of the company to foster individual, team and company growth.
• We actively participate in efforts to improve our many communities - internally and externally.
• We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
• We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements

• Stoop and bend.
• Sit and/or stand for extended periods of time while performing core job functions.
• Repetitive motions to include typing, sorting and filing.
• Light lifting and carrying of files and business materials.
• Ability to read and comprehend both written and spoken English.
• Communicate clearly and effectively.

Disclaimer

This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.