Manager, EDI Operations I

Location: Orange, California US

Notice

This position is no longer open.

Job Number: 1558

Workplace Type:

Position Title: Manager, EDI Operations I

External Description:

The Manager of EDI Operations is responsible for supporting Alignment Healthcare’s EDI Operations and will play a key role in operating a cloud-based data platform and its pipelines using Microsoft Azure cloud services.  This includes supporting key trading partner Joint Operations Committees (JOC) and fostering trading partner relationships. This role requires communicating effectively with all levels across the company and managing customer perceptions that build strong relationships throughout the company. This position facilitates ongoing collaboration with department leaders to develop electronic transaction strategies that align with business requirements, goals and initiatives. This position is also accountable for areas such as trading partner/clearinghouse strategies (including selection, orientation, development, and retention), Process/Systems selection and enhancement and best practices in secure electronic transmission technology. The Manager of EDI Operations role also requires familiarity with techniques that support monitoring and leading EDI SLA performance through various statistical and reporting methodologies.

General Duties/Responsibilities:

(May include but are not limited to)

  • Manages and leads the Data Operations Team (EDI and Pipeline) team including data acquisition, EDI and Pipeline transaction support, quality assurance, implementation support, and workflow management.
  • Provides accurate and timely IT project status to EPMO and other company project managers as well as coordinate enterprise activities and scope.
  • Manages service level performance for trading partners to the corresponding trading partner agreement.
  • Supports trading partner management that includes onboarding, continued support and sunset transition.
  • Manage data reconciliations between business partners data and internal databases.
  • Helps provide overall strategy for new electronic transaction formats.
  • Prepares metric dashboards and status reports for Monthly Operation Review meetings.
  • Other projects as assigned. 

Supervisory Responsibilities:

  1. Staff performance management.
  2. Staff recruiting and hiring.
  3. Vendor resource / Contract management.

Minimum Requirements:

  • This position requires a background in health care with extensive hands-on an EDI experience. Additional technical experience with EDI tool/mapping transaction technologies with specific experience with EZCAP / BizTalk / Logic Apps platforms. Applicant must be familiar with HIPAA 5010 Transaction sets (834, 835, 837, 820, 270, 271, 276, 277, and 278) as well as Clinical HL7 (ADT, CCD, CDA, etc.) transaction sets. The applicant must be results and people oriented with ability to balance business considerations.
  • Education and/or Experience: BA/BS or equivalent experience. Minimum 5+ years direct experience as an EDI, Operations Manager. Minimum 3+ years in healthcare operations or healthcare IT.
  • Certificates, Licenses, Registrations: EDI Certifications:  Any Leadership & Management Designation.
  • Project management skills and training (PMI certification desired).
  • Vendor management and/or clearing house relationship management. 

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  • While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
  • The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Manager, EDI Operations I

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].