Reporting to the Senior Manager, Health Plan Technical Delivery, the EDI Implementation Analyst III owns complex, high-visibility EDI implementations from a receiver perspective. This technical role applies advanced Availity system knowledge, independent judgment, and cross-functional partnership to analyze, design, implement, and improve scalable solutions that deliver consistent, high-quality outcomes.

Sponsorship, in any form, is not available for this position.

Location: Remote, US

To be qualified for the role, you have:

• Bachelor's degree or the equivalent work experience
• 6+ years of related experience in a technology, information exchange, EDI, and/or healthcare environment
• 6+ years managing moderate to highly complex implementations with independence, accountability, and sound judgment
• Knowledge of healthcare operations, including claims processing, provider office workflows, and customer service processes
• Understanding of HIPAA implementation guides for claim and other transactions
• Knowledge of HIPAA-mandated ANSI transaction formats
• Must have a working knowledge of X12 transactions specifically 837P, 837I, 835, 270/271, 276/277, 278
• Ability to develop and guide test plans, evaluate results, and resolve defects or dependencies
• Ability to create documentation such as training resources and reference materials
• Ability to establish and maintain effective working relationships, supporting internal and external partners
• Ability to influence cross-functional partners, identify risks, recommend solutions, and drive alignment
• Excellent written and verbal communication skills including strong presentation skills and the ability to present executive summaries in a concise manner
• Ability to translate complex information into clear recommendations and actionable plans
• Ability to effectively manage multiple priorities in a fast-paced environment
• Flexibility and ability to embrace change
• Ability to prepare documented customer requirements
• Experience with Submitters, Vendors and/or Receivers/Payers is a plus
• Customer service and/or relationship management experience is a plus
• Experience in software implementations is a plus

Key responsibilities include:

• Stakeholder management: Manage payer, vendor, partner, and cross-functional relationships to meet Program Management objectives.
• Implementation planning: Own deliverables, plans, requirements, testing strategies, and escalation paths.
• Communication support: Coordinate partner awareness of Availity functionality and support production issue communication with Operations and IT.
• Mentorship and improvement: Mentor analysts and improve processes to support quality, speed, and scalability.

Why work on this team:

• Opportunity to build broad technical, operational, and cross-functional expertise while supporting varied implementation work.
• Collaborate with a collaborative, knowledgeable, and supportive team.

What you will be doing:

Solutions Integration

Implementation Planning:

• Lead complex, high-impact implementations across submitters, partners, vendors, and receivers/payers for EDI, B2B, web, API, and other transaction methods using Availity processes and tools.
• Serves as a senior individual contributor and subject matter resource for EDI Implementation Analysts, providing guidance on complex implementations, technical considerations, and process standards
• Develop implementation plans, initiate customer workstreams, create required tickets, identify risks and dependencies, and recommend mitigation strategies.

Implementation Tracking and Execution:

• Manage multiple complex implementations, including timelines, dependencies, stakeholder alignment, issue resolution, escalations, and results delivery.
• Analyze standard and non-standard implementations, including HIPAA rules, Availity standards, customer requirements, integration options, and operational impacts.
• Lead pre-production testing with internal and external stakeholders, including test plan execution, defect resolution, and readiness validation.
• Tracks progress of specific implementation projects via Availity tools including JIRA, Confluence and Salesforce

Resource Coordination:

• Interacts with Payer/Trading Partner, Vendor and Provider Marketing, Business Development, Business Technology Solutions, Product Management, Finance, and Operations
• Communication and coordination between all Availity platforms
• Estimate scope, dependencies, risk, and level of effort for complex implementations.
• Manage workflow for moderate to highly complex implementations to meet quality, timeline, and stakeholder expectations.

Customer Relationship Management:

• Engage business, technical, internal, and external stakeholders on implementation solutions while representing Availity professionally.
• Support Sales, Account Management, and Payer Solutions with technical guidance, implementation recommendations, risk assessment, and solution options.
• Drive clean handoffs to Account Management or Operations to support market validation and solution adoption.
• Communicates new implementations and all related changes including detailed specifications
• Monitors customer communications (submitter, payer, trading partners, etc) to be apprised of any changes that may impact business operations (new edits, connectivity updates, system downtime)
• Partner with technology and development teams to confirm requirements, manage dependencies, and execute within expected timelines.

Operations Support

Process Documentation and Improvement:

• Lead development and improvement of support documentation, including production issues, impacts, solutions, escalation paths, lessons learned, and implementation standards.
• Document and improve testing procedures, implementation playbooks, workflow standards, and operational handoff materials.
• Responsible for documenting all information related to assigned implementations. Including but not limited to submitter and partner and vendor implementations, such as requirements, test plans, contact information, escalation procedures, etc.
• Recommend workflow improvements that support faster, higher-quality, and more scalable connectivity solutions.

Customer Support and Issue Resolution

• Provide senior-level analysis, troubleshooting, and escalation support for operational issues.
• Research, resolve, document, and communicate complex business, technical, and HIPAA issues to internal and external stakeholders.
• Supports and maintains implementations by execution of customer maintenance requests including but not limited to change requests, connectivity changes, and edit and enrichment enhancements.
• Support complex configuration, routing, and documentation changes, including partner migrations, alternate routes, and sustainable resolution recommendations.
• EDI Implementation Analyst IIIs will also be responsible for updating and maintaining payer routing and the payer list to ensure data is accurate. Including validation of payer routes to guarantee satisfaction.

Availity culture and benefits:

• Availity is a certified "Great Place to Work", a "Best Workplaces for Technology Companies", a "Best Workplaces for Women" and a "Best Workplaces for Millennials"!
• Culture is important to us and there are many ways for you to make your mark here!
• We have several Diversity & Inclusion teams and various ways to engage with fellow Availity associates. "AvaiLadies", "Beyond Black", "HOLA", "Availity Pride", "VetAvaility" a Young Professionals Group and "She Can Code IT" a group for women in tech are some of the groups you can get involved in.
• Availity is a culture of continuous learning. We have many resources and experts in our tech stack and in our industry that can help get you there too!
• We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!
• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.
• Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.
• Interested in furthering your education? We offer education reimbursement!
• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.
• Want to work for an organization that gives back to the community? You're at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.

Next steps:

After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process.

Interview process:

• Recruiter Video Interview
• Panel Video Interview
• Manager Video Interview
• Final interview with the hiring manager's manager

Video Camera Usage:

Availity fosters a collaborative and open culture where communication and engagement are central to our success. As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.

Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships. The usage of cameras also enhances security and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.