Job Summary:
This position supports TRICARE Prime® Demo by CareSource Military & Veterans, which aims to enhance healthcare access and prioritize the unique needs of the military community. We encourage military affiliated individuals, veterans, military spouses, and those with prior TRICARE experience to apply.
The Edifecs/EDI Tech Lead is responsible for owning technical delivery and technical management for a defined domain or platform. The role will work closely with cross-functional teams, including product managers, designers, and quality assurance, to ensure the successful delivery of solutions within the defined scope, timeline, and quality standards.
Essential Functions:
• Work with the EDI Manager to develop high-level implementation plans for the delivery of new technology; validate business proposition of this technology; evaluate currently deployed services and develop plan to optimize delivery
• Improve platform resiliency across all aspects of EDI, real time and batch transactions
• Prioritize team activities based upon IT leadership priorities and bandwidth
• Represent IT in project/business meetings and engagements
• Improve solution functionality and efficiency with added business value
• Collaborate closely with other business areas to optimize the use of systems and applications
• Apply creative thinking in problem solving and identifying opportunities for improvement
• Provide subject matter expertise for technical guidance, training and direction
• Provide direction, lead and review of work products and daily tasks for quality
• Design, architect, and oversee the development of complex software systems, ensuring scalability, reliability, and maintainability
• Drive the full development lifecycle, from requirements gathering and design to implementation, testing, and deployment
• Establish and enforce coding standards, best practices, and development methodologies within the team
• Conduct regular code reviews to ensure code quality, performance, and adherence to architectural principles
• Identify technical risks and propose effective mitigation strategies to ensure project success
• Accountable for EDI Service Level Agreements (SLAs) across all HIPAA transactions
• Collaborate with product managers to prioritize and schedule project deliverables based on business objectives and resource availability
• Provide accurate and timely progress updates to project stakeholders, highlighting achievements, challenges, and proposed solutions
• Stay up to date with the latest industry trends, technologies, and frameworks, and evaluate their potential application in the organization
• Perform any other job duties as requested
Education and Experience:
• Bachelor’s degree in Business, Computer Science or related field or equivalent work experience is required
• Five (5) years or more active experience within software development (Edifecs, Integration, Database, Portal preferred) required
• Five (5) years of experience working in a medium or large operating environment supporting 1,000,000+ transactions per month
• Five (5) years of programming and analysis experience
• Experience with Agile methodologies is required
• Experience with Edifecs (Smart Trading, Enrollment Manager, Encounters) preferred
• Experience translating business requirements into technical specifications
• Three (3) years of experience within Technology/Architecture leadership is preferred
• Project planning and project management experience is preferred
• Experience with Product Management environment and Cloud technologies is preferred
- Military affiliation or TRICARE experience is preferred
Competencies, Knowledge and Skills:
• Strong understanding of all EDI transactions in the healthcare domain (834, 837, 270/271, 276/277, 835, 820, 275, 278)
• Expert level skills in technical architecture, project management, and team collaboration
• Strong analytical, evaluative and problem solving abilities
• Knowledge of the healthcare and managed care philosophy is preferred
• Critical listening and thinking skills
• Strong learning competency and ability to teach others
• Solid project planning and management abilities
• Technical teaching, programming, analysis and specification skills
• Network protocols and security standards (may require)
• Application development tools methodologies (e.g. Agile) and Architecture skills
• Strong knowledge of best practices relative to application development or infrastructure standards
• Excellent written and oral communication skills
• Effective organization and prioritization skills
Licensure and Certification:
• Cloud certification a plus
Working Conditions:
• General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$92,300.00 - $161,600.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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