Director, Applications - Claims Processing
New
J
JobgetherHealthcare technology
Based in United States; fully remote work arrangement within the United StatesFull-TimeDirector
Salary105,958.12 - 229,575.94 USD per year
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Job Details
- Experience
- At least 8 years of IT applications or software development experience within large organizations; at least 3 years of management or technology leadership experience.
- Required Skills
- Microsoft Azure.NETCI/CDAzure DevOps
Requirements
- At least 8 years of IT applications or software development experience in large organizations, preferably in managed care or healthcare, or equivalent education and relevant experience.
- At least 3 years of management or technology leadership experience, including building and developing engineering teams.
- Advanced Microsoft Azure expertise, including App Services, Functions, AKS, Azure SQL, Data Factory, Synapse, and Azure DevOps.
- Strong proficiency with Visual Studio and AI-assisted development using GitHub Copilot and Azure AI services.
- Experience leading enterprise-scale quality assurance automation strategies and implementing testing frameworks.
- Advanced knowledge of Pega, Salesforce, and Sitecore and their integration within enterprise architectures.
- Healthcare payer experience, including Medicare, Medicaid, Marketplace programs, healthcare operations, and regulatory requirements.
- Experience with Trizetto QNXT or a comparable enterprise healthcare system.
- Strong understanding of software development lifecycle, IT general controls, test automation, enterprise infrastructure, and cloud-native architecture.
- Hands-on experience with .NET, Azure serverless technologies, Infrastructure as Code, CI/CD, Agile methodologies, and modern DevOps frameworks.
- Experience with Azure DevOps or Atlassian-based delivery environments, Microsoft Project or Jira, Microsoft 365, and Power BI.
- Experience working with global delivery models and third-party consulting organizations.
Responsibilities
- Lead the claims custom-solutions portfolio across adjudication, payment integrity, provider reimbursement, authorization, workflow, and regulatory initiatives.
- Govern solution intake, prioritization, funding, delivery, lifecycle management, and operational support.
- Partner with business stakeholders to translate complex needs into scalable technology solutions.
- Lead and develop Forward Deployed Engineers, setting expectations for end-to-end ownership and measurable business outcomes.
- Drive Azure cloud-native architecture and development, AI-assisted development, automation, CI/CD, Agile delivery, and DevOps practices.
- Oversee application implementations, integrations, enhancements, support, break-fix work, and large requests while maintaining service levels.
- Lead architecture and design reviews aligned with Azure patterns, security standards, HIPAA, and healthcare data-governance requirements.
- Monitor application stability, performance, and scalability, and implement proactive alerting and operational improvements.
- Manage strategic vendor relationships, cloud partnerships, consultancies, and build-versus-buy evaluations.
- Establish operational KPIs and coordinate cross-functional initiatives, governance, change management, budgeting, and planning.
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