Facets/Edi Developer II

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

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, understanding business processes, and developing solutions that support business applications. These solutions often involve integrating functionality across on-premises systems, external applications, business partner networks, and government sources. Collaborate with cross-functional teams, including IT and business stakeholders, to ensure seamless operations and meet customer needs. Manage time and expectations to deliver high-quality solutions that align with business goals and ensure stakeholder satisfaction.

Facets/EDI Developer II works 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.

The specific duties include the following:

• 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. Ensure that EDI transactions comply with industry specific 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%]

Requirements:

Bachelor's degree in Computer Science or a related field.

In addition, a minimum of two (2) years' experience which must include at least two (2) years' experience in each of the following:

• 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 required

Employer: PacificSource; Location: Springfield, OR; Salary: $87,000 per year. 40hrs/wk. Send resume and cover to Melissa.Shinney@pacificsource.com 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 live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• 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.