Senior EDI Developer

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Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

MGB Health Plan is seeking an experienced EDI Developer responsible for the design, development, implementation, and ongoing maintenance of healthcare EDI solutions supporting HIPAA transactions, including but not limited to 270/271, 276/277, 278, 820, 834, 835, 837, and 999. The idea candidate has a strong understanding of HIPAA EDI implementation and companion guides used across the healthcare industry to ensure compliant and reliable data exchange.

The EDI Developer must have hands‑on software development experience and demonstrate the ability to follow established design principles, coding standards, and best practices. The role works closely within cross‑functional project teams, adhering to SDLC processes throughout the lifecycle of development, testing, deployment, and support.

Strong technical proficiency is required, including C#/.NET development, SQL and related tools such as SQL Server Management Studio (SSMS), SSIS, T‑SQL, and experience working with Microsoft SQL Server. Experience using Visual Studio and Biz Talk Server in support of EDI and integration workflows is essential.

Experience with in healthcare payer environments is highly valued. Preferred qualifications include exposure to QNXT (claims and enrollment processing systems), ASP.NET development, and XML/XSLT programming, which support complex EDI transformations and integrations.

Primary Responsibilities:

Programming, including writing T-SQL in SQL Server and SSIS packages, which support the Vendor Interfaces.

Analyze business and system requirements, including impact analyses on existing systems, to develop systems specifications

In partnership with the business units, design, prepare and execute unit test plans for application upgrades and enhancements.

General data mapping of ANSI HIPAA EDI files, including coding, translation, development, testing and deployment or EDI applications.

Perform analysis on systems and processes to become a subject matter expert, in order to help and support the business units.

Work with hosted vendors to accomplish SDLC objectives-Provide data analysis support for NHP business areas in order to assist with the business areas’ information, reporting and application development needs.

-Data analysis entails understanding the flow of data and its interdependency among QNXT core modules such as Member Enrollment and Services, Claims Processing, Provider Relations, Clinical Systems and Finance.

Track and monitor problem tickets to insure timely resolution

Communicate status and escalate issues as needed.

Identify and resolve problems related to business processes and applications.

Coordinate and/or perform change and revision management to ensure inter-operability of…