Programmer

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

Under general supervision, provides assistance in the administration of activities within a group of services within the health care facility. Responsible for assisting several departments and the technical, managerial, ancillary, clerical and support staff of these departments.

Scope of Role & Responsibilities:

• Responsible for testing, maintaining, enhancing, and supporting HIPAA EDI (837, 835, 834, 270, 271, 276, 277, 278) transactions and applications.
• Implement new and update existing Companion Guides and Trading Partner Agreements.
• Supported day-to-day operations of EDI, including identifying any technical problems with sending/receiving transactions.
• Interface/Communicate with providers, vendors and internal departments to address technical issues related to EDI.
• Review electronic data received from providers/vendors to ensure presence and accuracy of critical data elements.
• Ongoing review of system setup and processes to ensure accurate and optimum setup for both provider and member selection.

• A Baccalaureate Degree from an accredited college or university with a major in Computer Science, Systems Engineering, applied Mathematics, Business Administration, Economics/Statistics, Telecommunications, Data Communications, or a related field of study; and
• Five (5) years of progressive, responsible experience in the field of data processing, computer systems and applications.
• Experience with HIPAA data transaction required.