The Senior EDI Specialist (Data Analyst) supports the fitness business unit by delivering quality member eligibility data to all downstream processes. The ability to obtain accurate membership files from our clients, and verify they are correct is vital to our processes for verifying program eligibility, processing fitness center payments, billing clients, and client reporting.
Key Responsibilities: Eligibility File Change Management
- Manage and create visibility for end-to-end business processes involving eligibility data streams.
- Eligibility Data Quality Control
- Develops tools for the measurement and controls of eligibility files; Uses these tools proactively to identify issues and escalate as appropriate.
- Identifies control points in the data continuum to validate file quality and quantity.
- Works directly with external clients and internal customers to resolve technical and content file issues affecting data intake processes and member access.
- Provides first-level response, investigation of root cause, and advanced troubleshooting to end users regarding eligibility data concerns.
- Collaborates with EIS DBAs in testing and remediation of data concerns, as well as database changes for new releases as it relates to member eligibility data.
- Drives data standard adoptions with external clients, via education and influence to drive workflow efficiency.
- Provides EIS with requirements for incorporating file changes into their load process and into our Operational Data Store (ODS).
- This position plays a key role by communicating file changes and business rules originating from the clients to our BT MIS team, and interfacing directly with Client Relations, EIS, and our clients to resolve issues.
- Works on problems of moderate scope where analysis of situations or data requires a review of a variety of identifiable factors.
- Strong written and oral communication skills, including presentation skills.
- Ability to lead cross-functional team meetings.
- Strong relationship building and interpersonal skills.
- Ability to analyze data and synthesize information clearly in order to devise solutions and influence action with customers.
- Ability to orchestrate reporting out of databases with Microsoft reporting/query tools.
- Ability to present findings and recommendations in a clear format to both clients and internal senior management staff.
- Knowledge of industry file format standards.
- Ability to capture and translate business requirements into EIS terms and EIS communications into business terms.
- Self-motivated, reliable, attention to detail, and dedicated individual with strong customer service background.
- Must possess excellent analytical skills and be proficient in root cause analysis.
- Exercises judgment within defined procedures and practices to determine appropriate action.
- Driven self-starter, with ability to perform research and issue analysis duties with little supervision.
- Adaptable and flexible to various methodologies and changes in environment.
- Experience working for or with health plans desirable.
- 3 years’ experience with EDI and other electronic data formats preferred.
- 5 or more years’ experience doing similar type work preferred.
- Bachelor’s degree in technology or related field preferred.
About Tivity Health:
Tivity Health® (Nasdaq: TVTY) is a leading provider of healthy life-changing solutions, including SilverSneakers®, Prime® Fitness WholeHealth Living® and Wisely Well™. We are actively addressing the social determinants of health, defined as the conditions in which we work, live and play. From improving health outcomes to reversing the narrative on inactivity, food insecurity, and social isolation and loneliness, we are making a difference and are transforming the way we do health. Learn more at TivityHealth.com.
Tivity Health is an equal employment opportunity employer and is committed to a proactive program of diversity development. Tivity Health will continue to recruit, hire, train, and promote into all job levels without regard to race, religion, gender, marital status, familial status, national origin, age, mental or physical disability, sexual orientation, gender identity, source of income, or veteran status.