Principal Information Systems Analyst - Lead EDI Developer (N387)

Heluna Health•Los Angeles, CA

1d•$48 - $69•Hybrid

About The Position

The Los Angeles County Department of Homeless Services and Housing (HSH) consolidates our countywide response to homelessness. The driving force behind HSH is increasing accountability and transparency, improving care for people experiencing or at risk of homelessness, and streamlining collaboration with partners including services providers, the County’s 88 cities, and unincorporated areas to deliver high-quality, life-saving care. Staff schedules are based on business need and may include the option of a hybrid work schedule where employees work remotely and from the office. The Principal Information Systems Analyst (Lead Electronic Data Interchange – (EDI) Developer) serves as the HSH technical lead for transforming data on homelessness services into Medicaid claims and managing the end-to-end Electronic Data Interchange – (EDI) workflow for claims billing. This role owns the production claims pipeline, ensuring accurate, compliant submission of claims, timely ingestion of acknowledgements and remittances, and rapid diagnosis of data quality and denial issues as services move through the claiming lifecycle. The position combines hands-on technical oversight with operational leadership, working closely with program partners, clearing houses, finance, and internal data engineering staff to maintain a reliable, auditable, and evolving claims process for non-traditional Medicaid services.

Requirements

Graduation from an accredited college with a bachelor's degree in Computer Science, Information Systems, or a closely related field, and four (4) years of progressively more responsible, full-time, paid experience in a centralized Information Technology organization performing information systems analysis and design for complex systems.
OR- Two (2) years of experience, within the last three years at the level of a Senior Information Systems Analyst
OR - Five (5) years of progressively responsible, full-time, paid experience in a centralized Information Technology organization performing information systems analysis and design for complex systems.
A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.
Successful clearance of the Live Scan process with the County of Los Angeles.
Substantial experience working with healthcare claims data and Electronic Data Interchange (EDI) in a production environment
Demonstrated experience with ANSI X12 transaction sets, including 837, 835, 999, and 277
Working knowledge of HIPAA transaction standards and Medicaid claiming rules
Experience using code-based data pipelines (Python, SQL, Scala, R, etc.) and modern cloud-based data platforms to cleanse and transform data
Experience collaborating with others and version controlling (e.g. GitHub) code-based pipelines
Proven ability to diagnose complex data and process failures, explain root causes to non-technical partners, and drive corrective action
Experience providing technical leadership, mentoring staff, or leading workstreams in a complex, cross-functional environment

Nice To Haves

Experience operating or supporting claims workflows involving non-traditional or non-clinical services, such as community-based, housing, or social support programs, is strongly preferred

Responsibilities

Operate and maintain the (existing) production pipeline that transforms homelessness service data into ANSI X12 837P transactions using Python-based workflows and clearinghouse translation tools.
Work with Data Engineering team to enhance or extend existing Python-based workflows as claiming requirements or program needs change.
Integrate eligibility and enrollment data, including bulk eligibility checks, into the charge capture and claim construction process
Submit claims through healthcare clearinghouses and monitor end-to-end transaction flow
Ingest, track, and manage EDI acknowledgements and remittances, including ANSI X12 999, 277, and 835 transactions, maintaining clear lineage from service records through payment outcomes
Identify, flag, and diagnose data quality issues, claim drop-off points, and denial patterns; coordinate and generate claim corrections and resubmissions
Ensure compliance with HIPAA transaction standards and applicable Medicaid claiming rules throughout the claims lifecycle
Lead technical discussions with program partners to refine service definitions, documentation standards, and claims workflows as program requirements evolve
Provide technical direction and day-to-day oversight to a direct report responsible for remittance analysis and billing-related data quality efforts
Collaborate with finance, analytics, and data engineering teams to support reconciliation, reporting, and continuous improvement of claims performance
Maintain clear technical and process documentation for claims workflows, controls, and system dependencies.
Support testing, validation, and onboarding of new service types or program configurations.
Contribute to process automation, monitoring, and quality assurance improvements across the claims pipeline.
Participate in cross-departmental initiatives related to Medicaid data, reporting, or system modernization.