Healthcare Technical Operations Manager

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $120k - $140k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 Technical Program Manager

🦅 H1B Visa Sponsor

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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 customer-facing technology delivery operations • Generate SLA and operational reports for customers and management • Drive incident resolution and root cause analysis • Manage daily production support for a mid-size health plan, including core administrative systems for enrollments, claims, adjudication, and payments • Support surrounding applications/products and upstream and downstream vendors • 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 with network, middleware, hardware, operating system, database, and external application groups • Plan system maintenance and upgrades across multiple vendors • Resolve customer escalations • Manage project staffing • Define improved methods that create ease and consistency • Coordinate with offshore teams and leadership • Provide on-call support after hours and weekends • Comply with the Code of Conduct, regulatory and contractual requirements, organizational policies, procedures, and internal controls

🎯 Requirements

• Bachelor’s degree or higher in business or a technical field, or commensurate experience • 6+ years’ experience managing a mid- to large-size customer-facing production support environment • Experience working in an onshore/offshore model • Experience in delivery management and customer partner or account interaction • Experience in a technical support role in a complex architecture environment • Experience with healthcare payer platforms such as Facets, QNXT, or NASCO • Experience managing production application environments • Strong service management, SLA tracking, and operational reporting experience • Strong Sev1/Sev2 incident response experience • Experience in high-governance and compliance environments • Experience coordinating partners for patching, enhancement requests, and incident management • Experience managing projects, tasks, and deliverables • Experience setting up processes using service management tools, preferably ServiceNow and Jira Service Management • Experience working with vendors • Strong Excel, PowerPoint, and presentation skills • SQL experience required • ITIL practices and software delivery experience required • Practical knowledge of SOWs, SLAs, and Change Requests • Strong communication, customer focus, planning, and coordination skills • AWS/GCP, SOAP, Healthcare EDI, and ETL processing experience desirable or highly desirable • ITIL certification is a plus • Ability to work Eastern Time hours • Ability to provide on-call support after hours and weekends • Candidates may be required to undergo a pre-employment criminal background check

🏖️ Benefits

• Remote work environment • Up to 5% travel • Reasonable accommodations for individuals with disabilities • Equal opportunity and workforce diversity commitment