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EDI & Eligibility Quality Analyst II

Collective HealthLehi, Utah, United StatesOnsite

At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.
Eligibility flows through and impacts every aspect of the Collective Health platform, and we are building out the team responsible for receiving, processing, validating and sending our eligibility information with our partners. We exchange a high volume of files per day with customers, networks, and partners, and are looking for people to be responsible for the operation, quality, and scaling of our data management systems. Through your experiences at Collective Health, you will be a pivotal part of improving the member healthcare experience by operating and scaling our data operations platform.

What you'll do:


  • Monitor quality and perform audits of configurations and EDI files.
  • Develop and apply deep understanding of all of the file formats ingested, generated, or sent by our systems.
  • Review file level validations to ensure they are being dispositioned correctly
  • Review member insurance card configurations to ensure accuracy with the printing service.
  • Innovate and continue to evolve QA tools to keep up with growth
  • Prioritize quality and building for scale – our team is growing fast so you’ll need to be ready for new challenges
  • Run calibration sessions with Eligibility leads
  • Review bugs during implementations to validate issues prior to engaging engineering

To be successful in this role, you'll need:


  • Project Management - understanding project plans and teams
  • Change Management - Solid understanding of creating/using/managing Change Management processes
  • Internal communications - being able to write/deliver constructive feedback
  • Experience working with Ben Admin and HR systems
  • Experience working with carriers
  • Understands US healthcare systems
  • Experience with Eligibility Implementations and file builds
  • Experience handling end to end projects at a small to mid sized organization or involvement in large scale projects as part of a x-functional team.
  • Ability to analyze large data sets

Pay Transparency Statement 


This is a hybrid position based out of our Lehi office, with the expectation of being in office at least two weekdays per week. #LI-hybridThe actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the hourly rate, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.Lehi, UT Pay Range$36.10—$45.10 USD

Why Join Us?


  • Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare
  • Impactful projects that shape the future of our organization
  • Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests
  • Flexible work arrangements and a supportive work-life balance

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com.

Privacy Notice


For more information about why we need your data and how we use it, please see our privacy policy: https://collectivehealth.com/privacy-policy/.

Life at Collective Health

Collective Health is powering the employer-driven healthcare economy with The Collective Health Platform, the world's first workforce health management system. Combining four solutionshealth plan, concierge support, engagement hub, and analyticsin one complete system, we're giving employers a platform to simultaneously manage their healthcare investment and take better care of their people. With more than 120,000 members and 30 enterprise clients, Collective Health is reinventing the healthcare experience for self-funded employers and their employees across the U.S. Headquartered in San Francisco, Collective Health has more than 350 employees and an experienced leadership team from some of the country's largest technology, insurance, and healthcare companies. The company has raised $230 million from investors including NEA, Founders Fund, GV, and Sun Life. For more information, visit https://www.collectivehealth.com.
Thrive Here & What We Value* Pay Transparency Statement* Hybrid Position Based Out of Our Offices: San Francisco, CA, Plano, TX, or Lehi, UT* Equal Opportunity Employer and Value Diversity at Our Company* Commitment to Providing Support to Candidates Who Require Reasonable Accommodation During the Interview Process* Transforming healthcare experience to be empowering and trustworthy* Collaborative work environment with a focus on customer delivery and innovation* Reducing administrative lift of delivering health benefits* Empowering employees in urgent, critical decisions* Emphasis on healthy long-term partnerships* Privacy Notice for More Information About Why We Need Your Data and How We Use It

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