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

Dental/vision insurance

401(k)

HSA/FSA

Life Insurance

Pet Insurance

Disability

Pre-paid legal

ID theft protection

Sick time

Paid leaves

EAP

Job summary

Innova Solutions seeks a Lead Healthcare Operations Analyst for a 6-month contract in Philadelphia, PA. The role focuses on monitoring operations across customer service, claims, enrollment, and training, with emphasis on quality controls and executive reporting.

Qualifications require 7+ years in self-funded medical insurance operations, quality assurance, and risk assessment, plus strong cross-team collaboration. Competitive hourly pay and comprehensive benefits are offered.

Qualifications

• 7+ years of experience in self-funded medical insurance operations, implementation readiness, quality assurance, issue management, or a related role.
• 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.

Responsibilities

• Monitor customer service, claims, enrollment, and related functions to identify gaps and trends.
• Conduct call listening and transcript reviews to spot misinformation, process breakdowns, and service risks.
• Establish intake, triage, ownership, escalation, and closure processes.
• Resolve routine questions and escalate issues needing leadership attention.
• Support initial training and readiness activities so teams understand the product and how to explain it.
• Implement monitoring and quality controls, verify corrective actions, and confirm changes work as intended.
• Maintain an integrated issue and action tracker with owners, priorities, status, and due dates.
• Provide concise executive-level status updates from operational reviews.

Skills

Self-funded insurance ops

Quality assurance

Issue management

Customer service ops

Job description

Lead Healthcare Operations Analyst

Position Type: Contract Duration: 06 Months Location: Philadelphia, PA

Responsibilities

• 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.

Qualifications

• 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.

Pay Range & Benefits

Pay Range: $43- $48 per hour

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.

This position qualifies for a Referral Bonus amount of $250-$1000 dollars.

• 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

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 [emailprotected] 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.