Be an Important Part of The Alliance’s Mission!
The Alliance serves as the voice for employers that self-fund their health benefit plans and want more control over their costs. We offer custom, high-value provider networks (SmarterNetworks℠) that drive serious savings for our clients while drastically improving their employees’ access to high-value health care.
We’re smart, confident, and optimistic; we have an undeniable passion for – and commitment to – improving the physical, emotional, and financial well-being of our clients and their employees. This is our life’s work, and driven by our shared values, we take it seriously but do it with a smile.
The Health Care Data Exchange Programmer / Analyst is critical to The Alliance’s success and helps ensure we provide outstanding service our clients. This role works to ensure all data transactions coming into and leaving the organization are accurate, timely, and meet the needs of The Alliance and our data partners. This programmer / analyst will be versed in the extraction, transformation, and loading of benefits eligibility data, provider network data, and Electronic Data Interface (EDI) X12 transaction sets, including medical claims data (837) and verifications (999). The role will build, maintain, and automate data transfer scripts with partners, troubleshoot issues around accuracy and timeliness of data, and work with The Alliance staff to help define data architectures to best support the mission of moving health care forward by controlling costs, improving quality, and engaging individuals in their health.
- Operational Claims Processing Data Interfaces – This role will work alongside other analysts and developers at The Alliance to further enhance how we deliver and disseminate data to our clients, providers, and consumers. The role is responsible for ensuring the accuracy of data and validity of analyses and work products in areas that span across the organization. Specific duties include:
- Develops and maintains processes to support Extraction Transformation and Loading (ETL) and troubleshooting between many clearinghouse, provider, and Third-Party Administrator (TPA) partners within The Alliance claims processing application.
- Support tools to load and maintain eligibility information from all TPAs
- Troubleshoots, tests, and performs root-cause analyses of data integrity and timeliness issues including a willingness to provide customer service support with external partners to help resolve operational issues
- Assists in the continued identification of tools, functions, architectures, and user interfaces to support the efficient process of medical claims through native The Alliance applications and web interfaces. This includes the ability to translate these needs into documented requirements for software development and to test newly developed features.
- Network Definition Interfaces
- Supports translation of in-network provider data for TPA partners to support novel benefit design concepts
- Supports translation of network data to meet specified needs for The Alliance and our partner-published network data
- Troubleshoots, tests, and performs root-cause analyses of observed data integrity and timeliness issues including a willingness to provide customer service support with external partners to help resolve operational issues.
- Supplies additional routine, structured data based on operational or warehoused data to support regulatory requirements, client, and provider needs.
- Claims and Other External Based Data Interfaces
- Supports and maintains development of ad hoc and routine data requests based on defined specifications
- Supports, maintains, and develops tools to assist with loading external data repositories to SQL based databases
In addition to solving problems and providing expertise in data tools, this role needs someone with strong written and verbal communication skills to interact professionally with both internal and external partners. Additionally, the ideal candidate will have:
- A bachelor’s degree, or equivalent experience, in information technology or a related field and with a focus on data integrity and interoperability work
- Five years’ experience in a professional setting
- Proven experience in data development, support, maintenance, and exchange in a health care setting. Preference given toward experience working with TPA, provider, and clearinghouse data partners and to candidates with a track record of successfully root-causing data integrity and timeliness issues and developing structures and tools to support continued efficiency. Experience with Transact Structured Query Language (T SQL), SQL Server Integration Services (SSIS), FTP Scripting, Shell scripting is required with additional consideration given to those with C#, Visual Basic, and FoxPro language experience.
- Experience with Microsoft Office Suite and Customer Relationship Management databases
This position can initially work remote, if desired, and post-pandemic the position can work remote one to two days/week.
As a not-for-profit cooperative, The Alliance is employer-owned and remains a trusted, objective partner for employers and their brokers who seek improved access to high-quality healthcare.
We’re Madison-based, but we work with 285+ employers across the Midwest and contract with over 31,000 doctors and health care providers in the region. Our goal is to help employers better manage their health care costs while remaining transparent and emphasizing value – creating healthier, more engaged workforces.
The Alliance is celebrating over 30 years as a mission-driven and member-focused collective with experienced leadership and strong organizational departments backed by top talent. By joining The Alliance, you’ll become part of a passionate, collaborative, and supportive organization: one that fosters meaningful connections and relationships with high levels of employee engagement and satisfaction.
Our health plan is self-funded, which means we share the same interests and use the same tools that we offer our clients. We lead by example, because when we take care of our employees, they take care of our clients (and their employees).
We set our staff up for success, encouraging not only their professional advancement but also their personal growth. We offer a competitive compensation and benefits package, including health/dental/vision/life insurances, a generous Staff Incentive Bonus program, 401(k), and annual Continuing Education and Wellness benefits.
The Alliance is unable to provide sponsorship for a H1-B work visa at this time.
Equal Opportunity Employer.