Eligibility EDI Analyst II

Our EDI Operations team plays a critical role in ensuring data integrity and operational success across Collective Health. We’re a highly collaborative group that partners cross-functionally with internal stakeholders and external partners to manage, maintain, and continuously improve eligibility and data file processes. As our team grows rapidly, we prioritize scalability, process refinement, and delivering best-in-class technical support.
As a Senior EDI Analyst, you’ll take ownership of complex data integrations and processes that are vital to our healthcare operations. This role is ideal for someone who thrives in a fast-paced, technical environment and enjoys problem-solving, mentoring, and cross-functional collaboration. Reporting to a team lead or manager within EDI Operations, you’ll drive quality, efficiency, and innovation in our file management processes—while helping others grow alongside you.

What you'll do:

• Own and manage the success of daily eligibility file processes and data management, ensuring smooth and accurate exchanges across the Collective Health platform.
• Leverage deep knowledge of file formats and data flows to monitor, troubleshoot, and resolve daily exceptions and errors effectively.
• Oversee operational ticketing systems, ensuring timely resolution of issues and team performance in alignment with SLAs.
• Take ownership of complex tasks and deliverables, including tasks like MA 1099s and Medicare reporting, ensuring accuracy and compliance.
• Navigate daily responsibilities with minimal oversight, applying expertise to independently handle challenges and deliver results.
• Continuously refine and improve processes, workflows, and documentation to enhance team efficiency and operational quality.
• Mentor and train team members, fostering the growth of their knowledge and understanding to elevate overall team performance.
• Lead root cause analysis for escalated issues, driving corrective actions and continuous improvements.
• Collaborate with internal teams (e.g., Product, Engineering, Implementation) and third-party partners to support and enhance existing integrations while overseeing the
• Implementation of new integrations—handling requirements gathering, file build coordination, testing, and go-live activities.
• Prioritize high-quality work and scalability, ensuring that systems and processes are optimized to accommodate growing business needs and evolving challenges.

To be successful in this role, you'll need:

• Required:
  • 3 to 5 years experience working with EDI files in healthcare.
  • Proficiency in Microsoft Excel and Google Workspace (G-Suite) for data analysis, documentation, and collaboration.
  • Strong cross-functional collaboration skills with a proven ability to work effectively across technical, operational, and client-facing teams.
  • Advanced problem-solving and analytical thinking skills, with the ability to identify root causes and implement effective, scalable solutions.
  • Experience mentoring peers and delivering training to support team development and knowledge sharing.
  • Advanced EDI expertise, including system configuration, data mapping, file testing, and reconciliation across partner integrations.
  • Knowledge of data architecture with the ability to work with large datasets
  • Background in technical, service-oriented environments with a strong focus on accuracy, customer impact, and operational excellence.
  • Exceptional task and time management skills, with the ability to prioritize effectively and manage multiple complex initiatives.
  • Proactive and clear communicator with demonstrated experience keeping stakeholders and leaders informed on status, risks, and decisions.
  • Strong understanding of eligibility and healthcare benefits data, with hands-on experience in the healthcare or benefits administration industry.
• Nice to have:
  • Foundational knowledge of SQL and Python and able to contribute to process automation or analysis.

Pay Transparency Statement 

This is a hybrid position based out of our Lehi office, with the expectation of being in office at least two weekdays per week. #LI-hybrid #LI-NM1

The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the hourly rate, you will be eligible for 20,000 stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.