Job #: 2924

Title: Director of Core Applications

Region:

  • New York City, NY
  • Job Type:

  • Contract
  • Contract Pay Rate:
  • $75-100
    • Anywhere
    • Posted 2 months ago

    Position Overview

    The Director of IT Core Applications is responsible for evaluating operation processes and procedures for process improvement of Core Applications. Will work with claims editing applications and vendors, Claims Operations, Utilization Management, and Network Management to setup system edits.

    Job Description
    Oversee development and implementation of short/long term business objectives
    Direct and support initiatives to focus on projects with plan wide benefit in accordance with corporate budgetary objectives
    Ensure continuous delivery of IT services through oversight of service level agreements and monitoring of IT systems vendor performance
    Oversee functions performed by delegated vendor as it relates to benefit configuration, claims processing, provider setup and account payable system
    Manage activities and communications between key business stakeholders and Core System Vendor for implementation of new systems and optimization of current systems
    Develop and oversee SDLC methodology, including business requirements creation and sign off, Quality Assurance, User Acceptance Testing, Production and Postproduction activities
    Address operational matters by working with business units to identify system solution to operational issues
    Participate and advise in new business/operational initiatives
    Provider guidance on current and future system capabilities
    Collaborate with operational areas and the system vendor to create system enhancement road map
    Identify areas of operational improvement, promote strategic relationships with business areas, vendor, governmental and partner organizations
    Work with claims editing vendors, Claims Operations, Utilization Management, and Network Management to setup system edit to increase medical cost savings
    Facilitate improvement of the payment transaction process by interacting with providers and finance team
    Manage project implementation of upgrades and new products as it relates to Core Systems
    Manage production processes, regulatory reports submission and provider directory activities
    Minimum Qualifications
    Bachelor’s Degree from an accredited college or university in Information Systems, Computer Science, Healthcare IT or related field
    A minimum of 15 years Data Processing related experience
    Healthcare IT experience required
    Project Management and Staff Supervision a plus
    Professional Competencies

    Integrity and Trust
    Customer Focus
    Functional/Technical skills
    Written/Oral Communication

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