Technical Operations Manager

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $120k - $140k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 Technical Program Manager

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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 enrollments, claims, adjudication, payments, surrounding applications, and 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 activities with network, middleware, hardware, operating-system, database, and external application groups • Plan system maintenance and upgrade events across multiple vendors • Resolve customer escalations • Support 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 technical field or commensurate experience in the field • 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 working in a technical support role in complex architecture environment • Experience with healthcare payer platforms (e.g., Facets, QNXT, NASCO) • Experience managing production application environments • Strong experience with service management, SLA tracking, and operational reporting • Strong experience handling Sev1 / Sev2 incident responses • Strong experience in high governance and compliance environments • Experience coordinating with partners for patching, enhancement requests, and incident management • Experience managing projects, tasks, and deliverables • Strong communication, planning, coordination, and customer-focus skills • Experience setting up processes using ServiceNow and Jira Service Management preferred • Experience working with vendors • Strong Excel, PowerPoint, and presentation skills • SQL required • Cloud AWS/GCP desirable • SOAP desirable • Healthcare EDI highly desirable (e.g., 270, 271, 276, 277, 834, 835) • ETL processing desirable • ITIL practices and software delivery experience required; ITIL certification is a plus • Practical knowledge of SOWs, SLAs, and Change Requests • Ability to foster partnerships and shared responsibility toward goals • Candidates may be required to complete a pre-employment criminal background check • Must work Mountain Standard Time hours • Ability to work across multiple time zones in a hybrid or remote work environment

🏖️ Benefits

• Remote work environment • On-call support opportunities after hours and weekends • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities • Equal opportunity and workforce diversity commitment