Healthcare IT Technical Operations Lead (Edifecs)

HealthEdge Software, Inc.; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

HealthEdge is seeking a Healthcare IT Technical Operations Lead to coordinate and streamline customer-facing tech delivery. Remote role with EST hours, up to 5% travel, and a pathway to strengthen operational excellence across enrollments, claims, adjudication, and payments.

Requires 6+ years in a production support environment and deep experience with EDI and payer platforms. You will partner with vendors, manage incidents, and drive SLA reporting while leading change and escalation processes

Qualifications

• Minimum of 6 years’ experience managing a mid to large size customer facing production support environment.
• Strong experience with healthcare payer platforms (e.g., Facets, QNXT, NASCO).
• Strong hands-on experience with EDIFECS/MoveIt.
• Strong hands-on experience with Healthcare EDI (270, 271, 276, 277, 834, 835).
• Experience with SQL and cloud environments (AWS or GCP) is desirable.
• Understanding ITIL practices; ITIL certification or strong working knowledge.

Responsibilities

• Manage operational excellence for technology delivery.
• Timely generation of SLA/Operational reports to customers and management.
• Driving issue resolution and root cause analysis for incidents.
• Manage day to day production support for a mid-size HealthPlan including support of core administrative systems (enrollments, claims, adjudication and payments), surrounding applications/products and downstream and upstream vendors.
• Addressing Edifecs and EDI issues in production.
• Driving customer calls and priorities.
• Prioritize daily operational events and issues.
• Managing incidents in the service management systems like JIRA/Service Now.
• Manage change and issue resolution activities with network, middleware, hardware, OS, DB, and external application groups.
• Plan system maintenance and upgrade events across multiple vendors.
• Customer escalation resolution.

Skills

Customer facing operations

ITIL practices

Problem solving

Education

Bachelor’s degree in a related field

Tools

EDIFECS/MoveIt

Healthcare EDI (270/271/276/277/834/835)

SQL

JIRA/ServiceNow

Cloud AWS/GCP

Job description

Overview

HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.

Healthedge is searching for a highly motivated Healthcare IT Technical Operations Lead to join our team. The IT Technical Operations Lead position will be instrumental in planning, coordinating and streamlining operational needs for customer facing technology delivery operations, guided by Healthedge’s values.

As a Healthcare IT Technical Operations Lead at Healthedge, you will be accountable for the following:

• Manage operational excellence for technology delivery
• Timely generation of SLA/ Operational reports to customers and management
• Driving issue resolution and root cause analysis for incidents
• Manage day to day production support for a mid-size HealthPlan including support of core administrative systems (enrollments, claims, adjudication and payments), surrounding applications/products and downstream and upstream vendors
• Addressing Edifecs and EDI issues in production
• Driving customer calls and priorities
• Prioritize daily operational events and issues
• Managing incidents in the service management systems like JIRA/Service Now.
• Manage change and issue resolution activities with network, middleware, hardware, OS, DB, and external application groups
• Plan system maintenance and upgrade events across multiple vendors
• Customer escalation resolution

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need:

• 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

Role Location: Remote

Working Hours: Eastern Standard Time

Travel: Up to 5%

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.

#LI-Remote

**The annual US base salary range for this position is $90,000 to $120,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will bedeterminedduring the interview process and is based on a combination of factors including, but not limited to,your skills, experience,qualificationsand education.