Core Systems & Operations Manager

MetroPlusHealth; New York (NY); On-site; USD 110,000 - 150,000; Full time

Job summary

MetroPlusHealth is seeking a Core Operations Manager to evaluate operational processes and improve core systems and applications. You will work with Provider Contracting, Credentialing, Claims Operations, Utilization Management, Network Management, and internal/external stakeholders to align systems with business needs.

You will track performance, coordinate with vendors, and support initiatives within approved budgets using Jira and ServiceNow, ensuring timely issue resolution and optimal

Qualifications

• Bachelor's degree in Information Systems, Computer Science, Health Information Management or Business Administration (Operations/IT/Healthcare focus).
• 5-7 years' experience in healthcare systems, especially payer systems like claims processing and benefit configuration.
• Project Management and staff supervision is a plus.

Responsibilities

• Evaluate and improve Core systems and applications across multiple departments.
• Track performance of core systems and vendors (claims processing, provider setup, benefits, AP workflows).
• Ensure initiatives stay on track using Jira and ServiceNow; review SLA performance.

Skills

Integrity & Trust

Customer Focus

Technical/Functional skills

Written & Oral Communication

Education

Bachelor's degree in IS/CS/Health IT/Business Admin

Job description

MetroPlusHealth is seeking a Core Operations Manager to evaluate operational processes and improve core systems and applications. You will work with Provider Contracting, Credentialing, Claims Operations, Utilization Management, Network Management, and internal/external stakeholders to align systems with business needs.

You will track performance, coordinate with vendors, and support initiatives within approved budgets using Jira and ServiceNow, ensuring timely issue resolution and optimal