EDI Architect

At Zelis, we Get Stuff Done. So, lets get to it!

A Little About Us

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts driving real, measurable results for clients.

A Little About You

You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview

Zelis is seeking an EDI Architect to lead the strategic and architectural direction of Electronic Data Interchange (EDI) across our organization. This is a high-impact, individual contributor role that complements our existing leadership structure while re-establishing a strong technical owner for EDI. You will serve as the single point of accountability for EDI architecture and strategy, ensuring alignment, scalability, and compliance as we grow and onboard new clients.

What You'll Do:

• EDI Strategy & Architecture Ownership

  • Define and drive the company-wide EDI architecture and strategic roadmap.

  • Ensure architectural consistency and scalability across all EDI implementations.

  • Serve as the final authority on non-standard mapping logic, especially where 835s are impacted, to ensure auditability and consistency.

  • Ensure our EDI architecture leverages best-in-class tooling and AI-driven capabilities to optimize data integration and future-proof our processes.

• Product Architecture & Compliance

  • Own the EDI product architecture, ensuring it meets the evolving needs of payers and providers.

  • Maintain compliance with industry standards (e.g., ANSI X12 4010/5010) and regulatory requirements (e.g., CMS, ONC).

  • Lead design efforts to integrate EHR systems, HIEs, and third-party platforms for real-time, compliant data sharing.

• Subject Matter Expert

  • Act as the go-to EDI expert for internal teams and leadership.

  • Provide guidance on client-specific decisions and best practices.

  • Lead the EDI implementation design for strategic client implementations

  • Represent the company in industry forums and working groups to promote collaboration and standardization.

• Cross-Functional Collaboration

  • Work closely with engineering and product teams to align on technical decisions.

  • Operate with autonomy to make architectural calls while fostering alignment across teams.

  • Collaborate with marketing, business development, and customer operations teams to ensure our EDI architecture supports the business strategy.

What Success Looks Like

• A unified, scalable EDI architecture that supports rapid client onboarding and long-term growth.

• Clear ownership and accountability for EDI decisions, reducing fragmentation and misalignment.

• High-quality, compliant EDI implementations that meet client expectations and industry standards.

• A trusted internal advisor who brings both historical context and forward-looking strategy to the table.

What You'll Bring to Zelis:

• 8+ years of experience in EDI architecture, strategy, or implementation, preferably in healthcare or dental services.

• Deep understanding of healthcare EDI standards, especially 835, 837, 277CA, 270/271, and related transaction sets.

• Experience with tools and technologies such as .NET (C#), Microsoft SQL, PowerBuilder, Selenium, and Rhapsody.

• Proven ability to lead cross-functional initiatives and influence without direct authority.

• Strong background in interoperability, including ADT, TOC, and CMS/ONC compliance.

• Familiarity with Agile methodologies and experience leading or mentoring Scrum teams.

• Excellent communication skills and a collaborative mindset.

• Experience managing vendor relationships and coordinating across internal and external stakeholders.

• Prior involvement in industry councils or working groups (e.g., National Dental EDI Council) is a plus.

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Location and Workplace Flexibility

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We welcome applicants from all backgrounds and encourage you to apply even if you dont meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.

Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com .

Disclaimer

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.