Lead Healthcare Operations Analyst

Innova Solutions Inc.; Philadelphia (Philadelphia County); On-site; USD 59,000 - 66,000; Full time

Benefits offered by this job

Medical & pharmacy coverage

401(k)

Referral bonus

Job summary

Innova Solutions is seeking a Lead Healthcare Operations Analyst for a client project in Philadelphia, PA. This contract role focuses on overseeing patient services, claims, enrollment, and related operations, identifying gaps and risks, and driving process improvements.

You will monitor performance, conduct reviews, establish streamlined intake and escalation workflows, and support training activities to ensure product knowledge and accurate communication across teams.

Qualifications

• 7+ years in self-funded medical insurance operations or related roles in complex service environments.
• Strong knowledge of customer service operations and interdependencies among service, claims, enrollment, training, and implementation.
• Experience identifying operational risk through call monitoring, transcript analysis, data review, or claims reviews.
• Ability to translate complex issues into clear executive-level guidance and reporting.

Responsibilities

• Monitor customer service, claims, enrollment, and supporting functions to identify gaps and trends.
• Conduct call listening and transcript reviews to spot misinformation and process breakdowns.
• Establish intake, triage, escalation, and closure processes with ownership definitions.
• Support training and readiness activities so teams understand product impact and messaging.
• Implement monitoring, quality controls, verify corrective actions, and validate changes.
• Partner with Project Manager to maintain an integrated issue tracker and provide updates.
• Connect issues across functions and recommend improvements.
• Document intake, triage, escalation, and resolution processes.
• Track issues with owners, priorities, status, and due dates.
• Provide regular operational findings and executive-level status updates.

Skills

Operational analytics

Call monitoring

Quality assurance

Risk management

Executive reporting

Process improvement

Job description

A client of Innova Solutions is immediately hiring for Lead Healthcare Operations Analyst

Position Type: Contract

Duration: 06 Months

Location: Philadelphia, PA

As a Lead Healthcare Operations Analyst you will:

• Monitor customer service, claims, enrollment, and supporting functions to identify gaps, inconsistencies, emerging trends, and areas requiring adjustment.
• Conduct frequent call listening and targeted transcript, claims, and enrollment reviews to identify misinformation, process breakdowns, training needs, and service risks.
• Establish practical intake, triage, ownership, escalation, and closure processes. Resolve routine questions directly and elevate issues requiring leadership attention.
• Support initial training and role-based readiness activities so impacted teams understand the product, how it affects their work, and how to explain it accurately.
• Implement monitoring and quality controls, verify corrective actions, and confirm changes are working as intended.
• Partner with the Project Manager to maintain an integrated issue and action tracker and provide concise updates on risks, trends, decisions, progress, and items requiring intervention.
• Connect issues across functions, reinforce effective practices, and recommend sustainable process, training, communication, or control improvements.
• Documented question intake, triage, escalation, and resolution process.
• Integrated issue and action tracker with owners, priorities, status, and due dates.
• Regular findings from operational reviews and concise executive‑level status updates.

The ideal Candidate will have:

• 7+ years of experience in self‑funded medical insurance operations, implementation readiness, quality assurance, issue management, or a related role in a complex service environment.
• Strong knowledge of customer service operations and the interdependencies among service, claims, enrollment, training, and implementation teams.
• Experience identifying operational risk through call monitoring, transcript analysis, data review, claims review, or similar quality activities.
• Strong judgment, organization, follow‑through, and ability to translate complex issues into clear guidance and executive‑level reporting.

Preferred:

• Health plan administration, benefits administration, claims operations, or similarly regulated experience.

This position is only open to applicants who can be engaged on a W-2 basis. 1099 contractors and Corp-to-Corp arrangements will not be considered for this position.

Referral Program

• Referral Bonus amount of $250-$1000 dollars.

Pay Range

Pay Range*: $43- $48 per hour

Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits

• Medical & pharmacy coverage
• Dental/vision insurance
• 401(k)
• Health saving account (HSA) and Flexible spending account (FSA)
• Life Insurance
• Pet Insurance
• Short term and Long term Disability
• Accident & Critical illness coverage
• Pre-paid legal & ID theft protection
• Sick time, and other types of paid leaves (as required by law)
• Employee Assistance Program (EAP)

About Innova Solutions

Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions:

• Named One of America’s Best Employers for New Grads by Forbes (2024)
• Named One of the Best Companies to Work for by U.S. News & World Report (Private Companies List, 2024-2025)
• One of the Largest IT Staffing Firms in the US - Ranked #3 by Staffing Industry Analysts (SIA, 2024)
• One of the Largest Staffing Firms in the US - Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
• Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
• One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
• AWS Advanced Tier Services Partner with 100+ certifications

Website

https://www.innovasolutions.com/

Equal Opportunity Employer Statement

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at [e-mail] or [phone]. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.

The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.