TEKVANA INC.

Analyst

• Lead the development, validation, and testing of EDI 834 enrollment files.
• Troubleshoot enrollment file issues and identify root causes.
• Interpret enrollment business rules and translate them into technical specifications.
• Provide guidance on state-specific and Marketplace/Open Enrollment requirements.
• Create detailed technical enrollment scenarios to support system testing and implementation.
• Convert business needs into clear technical requirements and functional documentation.
• Define expected system behavior and validate enrollment processing.
• Support enrollment operations teams by resolving complex enrollment and eligibility issues.
• Document business and technical requirements, workflows, and process documentation.
• Develop process flows and workflow diagrams.
• Act as a liaison between business stakeholders and IT teams to ensure successful implementation of enrollment initiatives.
• Monitor regulatory and Marketplace rule changes, particularly those impacting Open Enrollment.
• Interpret New York State Marketplace enrollment requirements and ensure compliance.
• Assess downstream impacts of enrollment and eligibility changes across integrated systems.
• Support planning, testing, and readiness activities for Open Enrollment.

EDI Analyst

QA Engineer

• Create and execute test cases and test plans
• Validate healthcare claims and benefits workflows in Javelina
• Perform functional, integration, regression, and UAT testing
• Coordinate with business and TPA teams to ensure quality deliverables
• Test AD-related access controls and troubleshoot networking issues
• Report, track, and verify defects through resolution

EDI Analyst

Quality Assurance Engineer – Healthcare