EDI Analyst II
Role and Responsibilities
The EDI (electronic data interchange) Analyst II is responsible for coordinating and implementing files between the Liviniti system and outside vendors, clients, and brokers. EDI Analysts are responsible for analyzing various specifications to work in conjunction with reports, interfaces, and mappings provided by data-trading partners. They coordinate and work with internal teams to complete EDI testing, implementations, and modifications of EDI files.
An EDI Analyst's primary responsibilities include analyzing file and system data to address and resolve any issues or errors, implementing and configuring file feeds for our existing or newly added vendors, and being the main EDI point of contact for your assigned clients. Key responsibilities include working closely with our vendors and internal teams at all levels of the organization to establish, support, and maintain all data exchanges.
• Responsible for the integration of any new vendor relationship using Electronic Data Interchange and file layouts for eligibility, accumulator, claim detail, and other files by obtaining EDI file specifications, file encryptions and transmission information from vendor.
• Build and maintain relationships with Liviniti' partners and other vendors; serve as liaison to bridge gaps between system partners and internal outward-facing staff.
• Document and provide scope of work to all parties involved in all stages of integration; noting customizations, routing rules, data mapping, etc. to ensure seamless integration process on client side
• Has solid technical understanding of different file types (fixed width, delimited, 834)
• Computer proficiency and technical aptitude with the ability to utilize various connectivity solutions (FTP/Secure FTP, Webfolders (WebDAV), VPN), and use of MS Office applications.
•Research, analyze, and understand data elements in Liviniti systems, as well as inbound and outbound vendor systems
• Develop mapping and translations between data elements for file feeds
• Coordinate and test EDI feeds with external vendors and internal file developers
• Maintain extensive knowledge of claims adjudication system requirements.
• Assist with any and all production EDI issues.
• Maintain awareness of and ensure adherence to Liviniti standards regarding privacy.
• Work on assignments that are complex in nature in which judgment and initiative are required in resolving problems and making recommendations
• Thorough knowledge of company and departmental policies and procedures.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
• Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
What We Have To Offer
Our benefits package is designed to keep our employees happy and healthy - physically, mentally and financially.
• Medical, Dental and Vision Insurance
• Disability and Life Insurance
• Employee Assistance Program
• Remote Work Options
• Generous Paid-Time Off
• Annual Reviews and Development Plans
• Retirement Plan with Company Match Immediately 100% Vested
Required Skills and Competencies
• Superior organization skills
• Passionate problem solver
• Fast-paced temperament
• Attention to detail is unprecedented
• Ability to analyze data and provide a detailed well written or oral response in a timely manner
• Prioritize work responsibilities and be able to maintain a proper balance between work and life duties while working remote
• Fast learner that's constantly looking to improve their knowledge, skills, and their overall job responsibilities
Supervisory Responsibility
There could be supervisory responsibilities in this role with Junior Analysts or Specialist reporting to this role.
Position Type and Expected Hours of Work
• Full-time/Salaried/Exempt.
• Some flexibility in hours is allowed, but the employee must be available during the "core" work hours of 8:00AM to 5:00PM CT. We cover clients from West to East Coast, work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends and holidays pursuant with industry demands.
Travel
This position has minimal travel expectations.
Preferred Education and Experience
• Bachelor's Degree
• Familiarity with multiple file types including 834, csv, pipe-delimited, fixed-width, xlsx, etc.
• Ability to read an 834 is a bonus
• Familiarity with file transfer protocols, specifically sFTP
• Experience with Microsoft Office, particularly Excel
• Understanding of SSH and PGP keys
• Experience with ticketing systems such as Zendesk
• Familiarity with HIPAA compliance
• Any familiarity with adjudication systems is a plus
• Organization, multitasking, and project management skills
Liviniti, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Liviniti, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Liviniti, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/V/D
PI6778b8145ec1-1794
Read LessParalegal - Contracts & Compliance REMOTE
Role and ResponsibilitiesAs Paralegal - Contracts & Compliance, responsible for supporting Liviniti's Legal and Compliance Department through contract administration, regulatory and licensing support, and day-to-day legal operations. This role prepares contracts and related documentation from standard forms, helps manage the legal ticketing and tracking processes, maintains contract files and databases, and supports timely follow-up on approvals, execution, and common redlines. The Paralegal also assists with licensing applications, renewals, reporting, subpoena coordination, and legal research, while helping maintain HIPAA-related documentation and other departmental SOPs. The Paralegal - Contracts & Compliance is required to perform the following duties and professionally undertake the following responsibilities:
Contracting Duties
Prepares client and vendor contracts and other legal documents from standard forms for review, approval, and use by Legal Counsel and Legal Department.Assists with online legal ticketing system, including reviewing ticket inquiries, preparing necessary documentation, responding to ticket inquiries, maintaining ticket organization, and adhering to expectations regarding turnaround times.Assists in maintaining the internal database for ticket and contract tracking.Files correspondence and legal documents in the companywide contracts database or file server.Assists with client and vendor contract follow-up for all company contracts and other legal documents sent out by the Legal Department.Assists in responses to redlines on common or standard requests in a timely manner.Assists in Request for Proposal tasks, as needed.Regulatory and Licensing Duties
Assists with coordinating, preparing, and submitting applications for all licenses and registrations within the company to ensure timely submissions and maintain licensing files.Assists with coordinating, preparing, and submitting annual reports and renewals for all licenses and registrations within the company and maintaining licensing files.Assists with coordinating, preparing, and submitting responses to Subpoenas within the company.Researches and analyzes law sources such as statutes, recorded judicial decisions, legal articles, and legal codes.General Legal Support Duties
Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.Abide by all obligations under HIPAA related to Protected Health Information (PHI).If a HIPAA violation is discovered, whether individually or by another, the violation must be reported to the Compliance Department.Assists with maintaining updated HIPAA policies and procedures within the company.Assists in maintaining and updating Standard Operating Procedure documents for the Legal Department.Assists with managing the legal calendar and inbox and other shared inboxes to include maintaining organization and responding timely to inquiries.Performs clerical duties such as scheduling appointments and providing information to callers.Assists Legal Counsel, Manager, and Administrator with various tasks, as needed.Participates in special legal projects, as assigned.Performs other legal and compliance duties, as assigned.Flexibility to understand, appreciate, and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
Required Skills and Competencies
Customer/Client Focus.Collaboration Skills.Communication Proficiency.Leadership.Problem Solving/Analysis.Time Management.Ethical Conduct.Learning Orientation.Technical Capacity.Thoroughness.Research and Writing Skills.Organizational Skills.Our Benefits Package is designed to keep our employees happy - physically, mentally and financially.
Medical, Dental, Vision InsuranceDisability and Life InsuranceEmployee Assistance ProgramRemote Work OptionsGenerous Paid-Time OffAnnual Reviews and Development PlansRetirement Plan with company match immediately 100% vested
Supervisory Responsibility
This position has no supervisory responsibilities.
Position Type and Expected Hours of Work
Some flexibility in hours, which will be determined by the supervisor, but the employee must be available during the "core" work hours of 8:00 AM to 5:00 PM CT. The company covers clients from the West to the East Coast; work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends, and holidays in accordance with industry demands .
Travel
No travel expected for this position.
Required Education and Experience Bachelor's degree (B.A.) or one to two years of related experience and/or training; or equivalent combination of education and experience. High degree of professional ethics and integritySound judgement and ability to analyze situations and information
Preferred Education and Experience: Healthcare compliance or paralegal certification.Additional legal research certifications and coursework. Experience with business registration or healthcare licensure applications with State authorities.
Liviniti, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Liviniti, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V
PIf5de27b14d1e-0416
Read LessThe BI Report Developer role will be responsible for developing and maintaining reports for internal and external use utilizing SQL Server Reporting Services and Power BI. The specific responsibilities include, but are not limited to, the following:
Create, troubleshoot, and maintain SSRS reports and their corresponding data sets.Create, troubleshoot, and maintain Power BI reports based on company endorsed data models.Collaborate with product owners, stakeholders and the BI team on reporting and analysis projects.Validate report functionality with internal staff and end-users.Collaborate with internal QA on acceptance testing and data validation.Adhere to development standard operating procedures including design specifications, unit testing and the BI development lifecycle.Abide by all obligations under HIPAA related to Protected Health Information (PHI).If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources.Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. What We Have to OfferOur benefits package is designed to keep our employees health and happy - physically, mentally and financially.
Medical, Dental, Vision InsuranceDisability and Life InsuranceEmployee Assistance ProgramRemote Work OptionsGenerous Paid-Time OffAnnual Reviews and Development PlansRetirement Plan with Company Match Immediately 100% Vested Required Skills and Competencies Experience with SQL Server 2008 R2 or above.Deep understanding of relational databases and query development using TSQL.3+ years of experience using SSRS development environments - Visual Studio and Report Builder 3.0.Experience developing Power BI reports.Strong communication skills. Strongly Desired Skills Understanding of Kimball/Star-Schema data warehouse database design.Development of reports using SQL Server Analysis Services Multidimensional.Knowledge of query development using MDX.Power BI modeling; DAX and M a plus.Experience with Agile Scrum and Kanban development methodologies.Experience in Healthcare/PBM/Pharmacy reporting.
Supervisory Responsibility
No direct supervisory responsibility.
Position Type and Expected Hours of Work Full-time/Salaried/Exempt.Some flexibility in hours is allowed, but the employee must be available during the "core" work hours of 8:00AM to 5:00PM CT. We cover clients from West to East Coast, work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends and holidays pursuant with industry demands. TravelThis position may require some travel.
Qualifications and Education Requirements Undergraduate degree in Information Systems or similar.3+ years SQL query development.3+ years SSRS development.Or equivalent combination of education and experience.
Liviniti, LLC and all entities provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Liviniti expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/V/D
PI5-
Read LessPharmacy Network Relations & Contracting Specialist - REMOTE
The Pharmacy Network Relations and Contracting Specialist is responsible for managing relationships with assigned pharmacy organizations, including regular communication, contract and reimbursement negotiations, and day-to-day service interactions with Liviniti. This role designs and implements strategies to build and maintain high-performing, compliant, and cost-effective pharmacy networks that align with Liviniti's fully transparent, 100% pass-through PBM model. Responsibilities also include partnering with Pharmacy Network Operations and other internal teams to ensure contract terms are accurately reflected in Liviniti systems and that claims are adjudicated correctly. Additional responsibilities may include representing the network relationship with external Liviniti clients and customers and serving as a subject matter expert for specific network product offerings. The Pharmacy Network Relations and Contracting Specialist is required to perform, but not limited to, the following duties and undertake the following responsibilities professionally:
Create, establish, build, and retain strong relationships with pharmacy network providers, owners, and staff across independent, chain, and specialty pharmacies.Understand and clearly articulate the value of Liviniti network participation for pharmacy providers, including reimbursement methodologies, clinical programs, and our pass-through model.Lead the end-to-end pharmacy contracting process (new contracts, renewals, amendments, and terminations) for assigned pharmacies and groups, ensuring contracts are accurate, compliant, and aligned with Liviniti's financial and service goals.Negotiate favorable but sustainable reimbursement and administrative fee structures with assigned and new pharmacy entities, using claims and performance data to support recommendations.Collaborate with Pharmacy Network Operations, Claims, Clinical Services, Client Services, and Implementation teams to ensure contract terms, rate tables, fees, and network attributes are correctly loaded and maintained in Liviniti systems.Monitor pharmacy network performance and stability for assigned regions or products, including participation status, reimbursement trends, and service issues; escalate and resolve concerns proactively.Respond to and resolve escalated inquiries from pharmacies related to contract terms, reimbursement, claims issues, network requirements, and performance expectations in a timely and professional manner.Support network strategy, RFP responses, and new client implementations by providing network information, completing network-related questionnaires, and assisting with access, gap, and disruption analyses.Assist in the development, rollout, and ongoing management of specialized network products (e.g., preferred networks, health system networks, limited/specialty networks) and related provider communications.Maintain accurate and current contract files, rate schedules, contact lists, and activity documentation in designated tracking tools, databases, and CRM systems to support audit, compliance, and reporting needs.Meet regularly with management, project teams, and functional team leaders within pharmacy network provider groups and employer clients to review performance metrics, provide network updates, collaborate on projects, participate in network management discussions, and resolve issues.Abide by all obligations under HIPAA related to Protected Health Information (PHI). If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources. Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company. Flexibility to understand, appreciate, and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
Our benefit package is designed to keep our employees happy and healthy - physically, mentally and financially.
Medical, Dental, Vision InsuranceDisability and Life InsuranceEmployee Assistance ProgramRemote work optionsGenerous Paid-Time OffAnnual Reviews and Development PlansRetirement Plan with company match immediately 100% vested
Supervisory Responsibility
The Pharmacy Network and Contracting Specialist will not have supervisory responsibilities or direct reports.
Position Type and Expected Hours of Work Full-time, salary/exempt position.Some flexibility in hours is allowed, but the employee must be available during the "core" work hours of 8:00 AM to 5:00 PM CT. We cover clients from the West to the East Coast; work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends, and holidays pursuant with industry demands.
Travel
This position could require up to 10% travel from your remote location.
Required Education and Experience Undergraduate degree or equivalent experience 3 years of provider relations and/or network management experience Preferred Education and Experience Master's degree2 years of experience in PBM or pharmacy management
Liviniti, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Liviniti, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V
PIacd02226ef49-8013
Read Less