Sr Director of IT - Healthcare Claim Systems

Innova Solutions is immediately hiring for a Director of IT Core Systems Position type: Fulltime Duration: PermanentLocation: Manhattan, NY (Hybrid)As a Director of IT you will:Oversee development and implementation of short/long term business objectivesDirect and support initiatives to focus on projects with plan wide benefit in accordance with corporate budgetary objectivesEnsure continuous delivery of IT services through oversight of service level agreements and monitoring of IT systems vendor performanceOversee functions performed by delegated vendor as it relates to benefit configuration, claims processing, provider setup and account payable systemManage activities and communications between key business stakeholders and Core System Vendor for implementation of new systems and optimization of current systemsDevelop and oversee SDLC methodology, including business requirements creation and sign off, Quality Assurance, User Acceptance Testing, Production and Postproduction activitiesAddress operational matters by working with business units to identify system solution to operational issuesParticipate and advise in new business/operational initiativesProvider guidance on current and future system capabilitiesCollaborate with operational areas and the system vendor to create system enhancement road mapIdentify areas of operational improvement, promote strategic relationships with business areas, vendor, governmental and partner organizationsWork with claims editing vendors, Claims Operations, Utilization Management, and Network Management to set up system edits to increase medical cost savings Facilitate improvement of the payment transaction process by interacting with providers and finance teamManage project implementation of upgrades and new products as it relates to Core SystemsManage production processes, regulatory reports submission and provider directory activitiesThe ideal candidate will have: Bachelor's Degree from an accredited college or university in Information Systems, Computer Science, Healthcare IT or related fieldA minimum of 10 years' systems/operations management-related experience Healthcare IT experience required Project Management and Staff Supervision a plusExperience implementing the claims system and UMCM go-live planned for the end of this year (first one)Background in system migration to assist with these multiple go-lives throughout 25 &26Experience working with large-scale implementationsReporting responsibility for system configuration (benefit and contract)-has two directors in this role, and they will report into this roleIn-depth knowledge of contract and benefit configuration would be a major plus, but not a deal breaker. Would also consider this experience in an acute care environmentExperience with Health Edge systems is a plus as wellThe current environment is legacy (PowerStepp and CareConnect); moving to HRP and Guiding Care through Health EdgeBenefit confirmation and contract configurationYou will need to have managed care or health plan experienceQualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.Thank you!Henry L Draper IIRecruting Lead770-255-7916henry.draper@PAY RANGE AND BENEFITS:Pay Range : $185k-$190k Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.Recent Recognitions: One of Largest IT Consulting Staffing firms in the USA - Recognized as #4 by Staffing Industry Analysts (SIA 2022)ClearlyRated Client Diamond Award Winner (2020)One of the Largest Certified MBE Companies in the NMSDC Network (2022)Advanced Tier Services partner with AWS and Gold with MSWebsiteSolutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@ or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

Created: 2025-10-02