Alignment Healthcare is a population health management company dedicated to changing the way health care is delivered in the United States. We are a fast-growing, highly dynamic organization that isn’t content with the status quo. We are looking for dedicated, innovative individuals who thrive in a fast-paced environment to join our team and help us carry out our vision - that is, to lead a movement that transformationally improves health care.

Join us today and we will give you every opportunity to succeed.

Manager, EDI Operations I

Location: Orange, California US

Apply

Job Number: 1798

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:

Who is Alignment Healthcare?

  • Socially responsible
  • Technologically enabled
  • Concierge care
  • Transformation
  • Servant leadership

We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.

We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.

EEO Employer Verbiage:

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.

This site supports the current version and the previous version of Internet Explorer, Chrome, Firefox, and Safari.