EDI Product Advisor, EDI Gateway - Evernorth - Remote

Candidates who reside within 50 miles of the following locations may be asked to work in person on a hybrid schedule (three days per week): Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, or Scottsdale, AZ.

Summary:

This position is responsible for driving Cigna initiatives through the development of and using industry standard formats, including the suite of HIPAA EDI transactions and custom API solutions from a business perspective, partnering with IT for technical components.

Primary responsibilities include participation in industry workgroups and conferences focused on the development of industry standards, taking a leadership role within an industry group, translating the technical standards into business friendly terminology and guiding subject matter experts in how to apply standards to enterprise initiatives.

This role reports to the Provider EDI Gateway Director and is responsible for electronic gateway initiatives.

The EDI transactions included in solutions work by this role include Provider, Client and Clinical related and cover all Cigna and Evernorth lines of business.

Responsibilities:


* Participate in or lead industry groups and discussions to monitor industry changes and drive for industry changes that align with Cigna goals.


* Develop working relationships with individuals in similar roles at other payers, provider and vendor organizations that you can collaborate with on industry standards questions.


* Read, understand and provide recommendation for changes on industry technical guides.


* Provide awareness on Industry Initiatives to key matrix partners and obtain input on how those initiatives align with enterprise strategies and priorities


* Develop and maintain awareness of industry trends, and gather industry expert opinion and quantitative market data for different market segments


* Work collaboratively with internal cross enterprise stakeholders to communicate information with external industry groups


* Maneuver through and transition from strategic organization view to complex process, policy, people and technology impacts


* Anticipate the needs of the healthcare industry 5-10 years in the future for industry standards development


* Understand and translate technical standards and requirements to be applied toward business scenarios and needs


* Assess a proposed mandate and provide feedback as to the impacts it has on Cigna and the provider.


* Consult with internal subject matter experts on industry initiatives current mandates and future mandates to assess gaps between current enterprise processes and the standard and technical guide requirements.


* Provide guidance and direction to internal partners on the application of the technical guides to solve specific business needs

Qualifications:


* Bachelor's degree or higher strongly preferred or equivalent work experience required


* 3+ years of EDI experience required


* 7+ years wor...