Manager Information Services

Drive the technological heartbeat of a comprehensive health plan enterprise as the Manager of Information Services. This critical leadership role sits at the intersection of healthcare strategy and information technology. You will oversee the structural integrity and integration of core health plan systems-including claims adjudication, EDI/X12, and advanced data analytics-ensuring seamless interoperability between providers, external partners, and major insurance entities. We are seeking a high-caliber leader who can bridge the gap between complex business problems and sophisticated technical solutions, all while front-facing with major payers, Medicaid, and Medicare., * System Lifecycle Management: Lead the development, integration, and deployment of new applications and system software enhancements across the entire Health Plan enterprise.

• Core Systems Oversight: Direct the management of essential health plan infrastructure, including claims adjudication, CRM, data warehouses, and reporting platforms.
• Data Interoperability: Oversee integration across health plan and provider networks, utilizing EDI, APIs, and Health Information Exchanges (HIEs) to ensure data fluidity.
• Strategic Problem Solving: Partner with IT leadership to create a cohesive enterprise architecture, translating company strategy into successful, implemented technical solutions.
• Operational Excellence: Review and analyze the effectiveness of existing applications to develop proactive strategies for business process improvement.
• Collaborative Liaison: Maintain strong partnerships with Infrastructure Services and key internal departments to ensure functional requirements and system compliance are met.
• Team Leadership: Manage a dedicated team, providing direction, coaching, and performance evaluations to foster a high-growth professional environment.
• Compliance & Policy: Cultivate and enforce functional policies, quality assurance best practices, and interface specifications to ensure system integrity.

Do you have experience in X12 EDI?, Do you have a Bachelor’s degree?, * Education: Bachelor’s Degree (Proof of education required at time of submission).

• Industry Experience: Direct Health Plan experience is mandatory. Candidates must have a deep understanding of health plan structures and third-party payer systems.
• Technical Expertise: Extensive experience with core health plan systems (Claims, EDI/X12, CRM, Data Warehousing).
• Leadership: Proven track record in staff development, hiring, and performance management., * Payer Relations: Demonstrated ability to interact effectively with major insurance companies, Medicaid, and Medicare.
• Architectural Vision: Strong understanding of enterprise architecture and the ability to leverage technology to solve complex business challenges.
• Analytical Skills: Proficiency in leveraging analytics platforms to drive executive decision-making.

$60 - $61 an hour - Full-time, Contract