Healthcare Claims Technical Operations Manager

HealthEdge is seeking a highly skilled and experienced COE Manager to join its growing team. The Manager, Claims Ingestion Center of Excellence (COE), will be instrumental in planning, coordinating, and optimizing all claims ingestion operations across UST HealthProof's customer-facing delivery ecosystem.

Requirements

• Bachelor's degree in a business or technical field, or equivalent experience
• 6+ years of experience managing a mid- to large-scale production support or operations environment
• Deep experience with healthcare payer claims, including SNIP levels, EDI validation, and claims intake workflows
• Strong expertise with EDI transactions, particularly 837, 270/271, 276/277, and 835
• Experience working with healthcare payer platforms such as Facets, QNXT, NASCO, or similar
• Strong knowledge of service management tools such as Jira Service Management and ServiceNow
• Strong experience supporting high-governance and compliance-controlled environments
• Ability to manage Sev1/Sev2 ingestion incidents with confidence and urgency
• Experience with SQL required; experience with ETL, SOAP, cloud platforms (AWS/GCP), and HealthEdge applications is a plus
• ITIL knowledge or certification preferred
• Proven experience leading teams, driving process improvement, and establishing operational best practices
• Experience working in an onshore/offshore delivery model
• Strong communication skills and the ability to interact effectively with peers, vendors, customers, and leadership
• Strong planning, coordination, and documentation skills

Benefits

• 401k Matching
• Generous Paid Time Off
• Health Insurance
• Paid Vacation Time