Senior EDI Operations & Provider Connectivity Lead

Bcbsla; Baton Rouge (LA); On-site; USD 120,000 - 150,000; Full time

Job summary

Blue Cross and Blue Shield of Louisiana is seeking a senior leader to direct the EDI Customer Operations team, overseeing provider connectivity solutions, clearinghouse operations, and provider-facing digital platforms. You will drive performance, compliance, and continuous improvement across daily transaction processing and customer support.

The role requires strong leadership, HIPAA/EDI expertise, and collaboration with cross-functional teams to ensure secure, timely data exchange and service

Qualifications

• Bachelor’s degree in Computer Science, Information Systems, Business Administration, Healthcare Administration, or a related field.
• Four years of directly related experience may be substituted for a degree.
• 5 years of experience in healthcare operations, EDI, provider connectivity, systems operations, healthcare technology, or a related field.
• 2 years of leadership experience.
• Advanced knowledge of HIPAA Transactions and Code Sets, healthcare EDI standards, and electronic healthcare transaction processing.
• Strong understanding of healthcare claims, clearinghouse operations, provider connectivity, and related business processes.
• Demonstrated ability to lead operational, technology, and process improvement initiatives.
• Proven analytical, critical-thinking, and problem-solving skills.

Responsibilities

• Provides leadership, direction, and development for staff responsible for EDI operations, provider connectivity, systems support, implementation activities, and customer support services.
• Oversees the organization’s electronic transaction ecosystem and provider-facing digital services, ensuring system reliability and compliant data exchange.
• Ensures compliance with HIPAA, CMS, and state/federal regulatory requirements governing electronic transactions and data exchange.
• Leads operational support, incident management, root-cause analysis, process improvement, automation, and technology enhancement initiatives.
• Monitors operational performance through metrics, reporting, forecasting, and trend analysis.
• Manages strategic planning, budgeting, resource allocation, vendor relationships, and priorities to support business needs.

Skills

EDI Operations

Team leadership

HIPAA knowledge

Provider connectivity

Project management

Analytical thinking

Cross-functional collaboration

Education

Bachelor’s degree in Computer Science, Information Systems, Business Administration, Healthcare Administration, or a related field

Job description

Blue Cross and Blue Shield of Louisiana is seeking a senior leader to direct the EDI Customer Operations team, overseeing provider connectivity solutions, clearinghouse operations, and provider-facing digital platforms. You will drive performance, compliance, and continuous improvement across daily transaction processing and customer support.

The role requires strong leadership, HIPAA/EDI expertise, and collaboration with cross-functional teams to ensure secure, timely data exchange and service