Healthcare Core Systems Analyst & Configuration Lead

MetroPlusHealth; New York (NY); On-site; USD 110,000 - 140,000; Full time

Job summary

MetroPlusHealth seeks a Core Operations Manager to evaluate and improve core systems and applications, partnering with Provider Contracting, Credentialing, Claims Operations, Utilization Management, Network Management, and other stakeholders to align systems with business needs.

You will drive system configurations, manage vendor relationships, monitor SLAs, and guide cross-functional teams through system updates and migrations in a fast-paced health plan environment.

Qualifications

• Bachelor’s degree in Information Systems/MIS, CS, Health Information Management, or Business Administration (Operations/IT/Healthcare focus)
• 5–7 years in healthcare systems, with payer modules like claims, benefits, provider data, testing/migration
• Project Management and Staff Supervision a plus

Responsibilities

• Track performance of core systems and vendors (claims processing, provider setup, benefits)
• Manage initiatives aligned to corporate budget objectives
• Ensure SLA performance and escalate as needed
• Coordinate communication between business units and Core system vendors
• Advise in new business and operational initiatives for system capabilities
• Collaborate with Claims Ops, Utilization Mgmt, and Network Mgmt for use cases

Skills

Project management

Staff supervision

Stakeholder communication

Healthcare domain knowledge

Education

Bachelor’s degree (IS/MIS/CS/Software Eng/Health Info Mgmt or BA in Ops/IT/Healthcare)

Tools

Jira

ServiceNow

Job description

MetroPlusHealth seeks a Core Operations Manager to evaluate and improve core systems and applications, partnering with Provider Contracting, Credentialing, Claims Operations, Utilization Management, Network Management, and other stakeholders to align systems with business needs.

You will drive system configurations, manage vendor relationships, monitor SLAs, and guide cross-functional teams through system updates and migrations in a fast-paced health plan environment.