Healthcare IT Technical Operations Lead, Edifecs

🕒 October 16

🇺🇸 United States – Remote

💵 $90k - $120k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Manage operational excellence for technology delivery • Generate SLA and operational reports for customers and management • Drive issue resolution and root cause analysis for incidents • Manage day-to-day production support for a mid-size health plan, including core administrative systems for enrollments, claims, adjudication and payments • Support surrounding applications/products and downstream and upstream vendors • Address Edifecs and EDI issues in production • Drive customer calls and priorities • Prioritize daily operational events and issues • Manage incidents in service management systems such as JIRA and ServiceNow • Manage change and issue resolution activities with network, middleware, hardware, operating system, database and external application groups • Plan system maintenance and upgrade events across multiple vendors • Resolve customer escalations

🎯 Requirements

• Bachelor’s degree in a related field • Minimum of 6 years’ experience managing a mid to large size customer facing production support environment • Strong experience working with healthcare payer platforms (e.g., Facets, QNXT, NASCO) • Strong experience with service management, SLA tracking and operational reporting to customers and management • Strong hands-on experience with EDIFECS/MoveIt required • Strong hands-on experience with Healthcare EDI required (e.g. 270, 271, 276, 277, 834, 835) • Experience managing health of production application environments • Experience working in a technical support role in complex architecture environment • Experience with SQL required • Experience with Cloud AWS/GCP desirable • Experience with SOAP desirable • Experience ETL processing desirable • Understanding of ITIL practices and software delivery • ITIL certification or strong working knowledge of ITIL-based operations • Practical knowledge of working with SOWs, SLAs, and Change Requests • Experience working with SaaS providers and HealthEdge applications is a plus • Experience in delivery management and customer partner or account interaction is a must • Experience working in an onshore/offshore model is a must • Ability to work Eastern Standard Time • Willingness to travel up to 5% • Candidates may be required to complete a pre-employment criminal background check

🏖️ Benefits

• Remote work • Up to 5% travel • Equal opportunity employer • Reasonable accommodations for individuals with disabilities • Pre-employment criminal background check

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