Senior Implementation Consultant - Healthcare

The Senior Implementation Consultant assists in the testing and implementation of Edifecs solutions purchased by clients. The Senior Implementation Consultant will be involved in installing and configuring under the direction of the Technical Project Manager and/or Implementation/Solution Architect. This includes installation of products on client hardware; configuration and development of programs, tasks and guidelines, and setup to fully implement an Edifecs solution. Duties can range from delivery of product training to new client specific requirements, development and deployment. The role involves client coordination and communication as well as technical understanding of the Edifecs solutions and the transactions that flow through this position.

System Implementation and Configuration

• Implement and configure Edifecs applications for payer systems on AWS, Azure cloud or virtual machines.
• Implement and manage integrations between Edifecs’ products and solutions and Customer’s on-premises
• systems.
• Analyze business requirements and translate them into technical configurations, workflows, and mapping documents.

Integration and Data exchange

• Develop and test real-time and batch integrations using:
  • EDI (X12: 834, 837, 835, 270/271, 276/277, 278)
  • FHIR (CMS Interoperability APIs)
  • HL7 v2/v3, or latest version
• Implement service-based integrations via RESTful APIs, SOAP Web Services, ESBs, and iPaaS platforms.
• Create mapping specifications and perform data validation, reconciliation, and error resolution.

Data Strategy & Migration

• Support ETL processes and legacy data migration to new payer systems.
• Perform data profiling, cleansing, transformation, and loading activities.
• Assist QA teams with creating technical test cases and validating system configurations and interfaces during SIT/UAT.

Collaboration & Delivery

• Partner with business analysts, SMEs, solution architects and delivery leads to ensure alignment of technical deliverables.
• Develop appropriate training and development plans to meet the client's particular maintenance level and to configure the software according to the project plan.
• Provide post-implementation support during the transition from implementation to maintenance.
• Provide software and client specific training and develop training documentation based on present standards and client needs.
• Participate in design workshops, integration sessions, and go-live readiness planning.
• Provide technical guidance to junior implementation staff and contribute to solution documentation.

• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Education and Experience

• Bachelor’s in computer science, Information Technology, Information Systems or other technology related degree or equivalent experience in implementing, and operating Java stack-based enterprise applications.
• 5+ years of experience in technical healthcare system implementation, preferably with a payer or health plan.
• 3+ years of experience with Electronic Data Interchange (EDI) mapping and EDI analysis.
• Deep understanding of X12 standards, FHIR and other standards-based interoperability / integration patterns in the Healthcare Industry.
• Hands on experience in analyzing transactions and creating interfaces for transactions such as X12 837, 835, 834, proprietary formats and deep knowledge of coding standards such as LOINC, SNOMED, ICD 10.

Technical Skills

• Familiarity with data formats: JSON, XML, HL7v2 messages, X12, flat files (CSV, pipe-delimited, etc.).
• Strong knowledge of Edifecs Applications, preferred.
• Decent knowledge of healthcare EDI transactions (834, 837, 835, 270/271, 278).
• Proficient in data modeling (logical & physical) and relational databases (SQL Server, Oracle)
• Experience implementing solutions on AWS, Azure using CI/CD pipelines (GitLab, Jenkins, Terraform, CloudFormation)
• Experience working in Agile or SAFe environments.
• Working knowledge of java programming language and good understanding of SOAP and REST based webservices
• Prior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions.
• Prior experience in troubleshooting problems in java-based applications using opensource tools / JDK tools such as jstack, visualvm, jconsole, jmap and similar tools to identify memory issues, deadlocks, application performance.
• Experience using integration engines or tools (e.g., Mirth Connect, InterSystems, AWS Glue, Talend) is a plus.
• Expertise with healthcare data domains: member, claims, provider, enrollment, and clinical data.

Soft Skills

• Strong analytical and problem-solving skills.
• Clear communication, with ability to document and explain complex technical concepts to stakeholders.
• Detail-oriented and highly organized, with a strong focus on data quality and compliance.
• Collaborative team player who can work across services, product, engineering, and business teams.

Preferred Qualifications

• AWS or Azure Certified or equivalent cloud certification.
• HL7 or EDI professional certification.
• Experience in CMS regulatory implementations.
• Prior consulting or vendor-side implementation experience with health plans.
• Experience automating data validation and transformation processes.

Cognitive/Mental Requirements

• Communicating with others to exchange information.
• Problem-solving and thinking critically.
• Completing tasks independently.
• Interpreting data.
• Making timely decisions in the context of a workflow.
• Maintaining focus.
• Assessing the accuracy, neatness and thoroughness of the work assigned.
• Learning new tasks and completing tasks in situations that have a speed or productivity quota.
• Remembering and adhering to processes and protocols.
• Applying established protocols in a timely manner.

Working Conditions and Physical Requirements

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands and/or fingers.
• Must be able to provide high-speed internet access / connectivity and office setup and maintenance.
• Must be able to provide a dedicated, secure work area.

Base compensation ranges from CAD $99,500 to $128,500 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of Posting: 4/9/2026.

We anticipate that the application window will close on 4/16/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

Since this job will be based remotely, all interviews will be conducted virtually.

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