Job Information
CareOregon IS Development Manager - EDI in Portland, Oregon
Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.
Job Title
IS Development Manager - EDI
Exemption Status
Exempt
Department
Business Intelligence
Manager Title
Director, Claims Systems and Electronic Data Interchange
Direct Reports
EDI Development Team
Requisition #
24170
Pay & Benefits
Estimated hiring range $140,640 - $170,170 / year, 5% bonus target, Full benefits. www.careoregon.org/about-us/careers
Job Summary
This position is responsible for managing cross-functional software development teams comprised of a range of technical roles and responsibilities. This position is in charge of managing a team or teams which are focused on Electronic Data Interchange (EDI) analysis and development. This position assesses current technical architecture; evaluates and proposes architectural and design changes; and leads implementation of changes to system architecture to improve reliability, maintainability, and upgradability of the system. This position maintains oversight over technical choices, development of software code, configuration and infrastructure set up. Additionally, this position oversees and ensures the timely resolution of any production issues associated with the systems managed by their team.
Essential Responsibilities
Operational Planning and Oversight
Participate in long-term EDI systems architecture planning.
Create systems architecture plans with focus on taking advantage of new cloud technologies, resolving challenges encountered, and setting up system for scale to handle future volumes.
Develop 18-to-24-month EDI roadmap for system improvements in consultation with appropriate stakeholders.
Plan and execute regular releases/upgrades as per agreed roadmap.
Implement changes to system to support enterprise project requirements.
Maintain visibility into vendor and partner roadmaps and appropriately adjust roadmaps, plans, and priorities to maintain low technical debt.
Develop resource and capacity plans for team’s direction and roadmaps.
Manage and oversee the operations and performance of all areas of responsibility to ensure organizational effectiveness.
Work collaboratively with other teams within Information Systems Business Intelligence (ISBI) to provide expertise, support, and capacity to solve larger cross team challenges, facilitate resolution of intermittent issues and support processes spanning multiple teams.
Develop and maintain strong relationships with stakeholders in other business units and peers in ISBI; collaborate effectively with these groups.
Create consistency in IS development processes and communicates these clearly to IS and non-IS groups.
Communicate plans and intentions clearly to IS and non-IS groups; incorporate best practices for design, architecture, development, and support.
Technical/Operation Leadership
Lead the execution of strategic initiatives, plans, and goals and contributes to organizational vision and goals.
Provide continuous evaluation of CareOregon’s EDI systems in support of scale, agility, and stability to meet existing and emergent organizational needs.
Establish and maintain an implementation teams to implement near term and ongoing improvements to systems.
Lead innovation, process reviews, and improvement efforts; improve processes and procedures to ensure compliance with regulatory bodies and statutes, including HIPPA standards for PHI protection and transmission.
Refine business and systems requirements for new information technologies in support of application rationalization and modernization.
Maintain and enhance existing systems; discontinue systems no longer cost effective.
Develop, monitor, and report on KPIs, metrics and SLAs across the team.
Ensure compliance with internal auditing, HIPAA, and other federal regulations.
Promote ISBI programs and staff achievements across the organization through regular and transparent reporting, as well as publishing workplans.
Provide operational leadership for ISBI teams by recommending, developing, and implementing third-party solutions.
Act as project leader on complex software development programs.
Exercise sound business and technical judgement in making effective technical decisions for design and architecture of systems.
Ensure technical documentation is established and maintained for systems and related components and processes for technical focus area.
Project Management and Participation
Plan, organize, manage, and monitor work projects.
Act as project manager for projects related to system improvements for technical focus area.
Ensure project deliverables are met according to quality control schedules and standards.
Develop plans and processes to eliminate need for internal project management team’s engagement for routine operational projects such as releases, version upgrades, technology stack upgrade, etc.
Utilize ServiceNow or similar tool for managing resources, work plans and commitments.
Perform business needs analysis and develops functional requirements for technical focus area as needed.
Relationship Management
Lead effective communication system for work groups, ensuring a collaborative culture.
Build and ensure effective relationships across internal teams and external organizations for current or future integration.
Liaise between the IS Development teams, other IS groups and non-IS business partners.
Partner with internal leaders and managers to identify improvement plans and processes.
Partner with or lead other ISBI leaders in support of project management, release management, change management and incident management decisions and administration.
Develop and maintain knowledge of CareOregon’s critical functions that support our members and patients; collaborate with stakeholders to understand informational requirements to support department goals.
Represent CareOregon within and outside the organization, providing productive leadership presence and effectiveness.
Establish and maintain cooperative and productive working relationships with internal and external customers.
Work collaboratively to resolve complex system problems and assist internal and external user departments as required.
Employee Supervision
Manage team(s) and recommend team direction and goals in alignment with the organizational mission, vision, and values.
Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity, and inclusion lens.
Plan, organize, schedule, and monitor work; ensures employees have information and resources to meet job expectations.
Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.
Train, supervise, motivate, and coach employees; provide support toward employee development.
Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision making.
Ensure team adheres to department and organizational standards, policies, and procedures.
Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).
Perform supervisory tasks in collaboration with Human Resources as needed.
Organizational Responsibilities
Perform work in alignment with the organization’s mission, vision and values.
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals.
Adhere to the organization’s policies, procedures and other relevant compliance needs.
Perform other duties as needed.
Experience and/or Education
Required
Minimum 8 years’ EDI Domain relevant experience
Minimum 3 years’ experience with one or more of the following: Biztalk, Edifecs, MuleSoft, QNXT
Minimum 3 years’ experience leading development teams with senior software Healthcare EDI developers, including leading teams accountable for systems design, implementation, and support
Experience with Healthcare Domain, EDI HIPAA transaction types and ANSI X12 data (837, 835 and 834)
Experience with Agile methodology
Preferred:
Experience with Encounter Management and Risk Adjustment Cycle Management
Experience with Medicaid and Medicare programs
Experience with Healthcare Domain, EDI HIPAA transaction types and ANSI X12 data (820, 270/271, 276/277, 278, 997, 277CA, 277U, 824, NCPDP, and Encounters Submission Process)
Experience with transforming EDI data into XML for consumption by other systems or processes.
Experience implementing an EDI platform
Experience with migrating Biztalk to MS Azure Logic Apps or comparable solution.
Information Technology Information Library (ITIL) Certification
Project Management Professional (PMP) certification or other project management training and experience in managing large projects.
Master’s or equivalent in Business Administration with focus on Information Technology
Minimum 2 years' experience in a supervisory position or minimum 1 year experience in a supervisory position and completion of CareOregon's Aspiring Leader Program
Knowledge, Skills and Abilities Required
Knowledge
Knowledge of Healthcare Domain, EDI HIPAA transaction types and ANSI X12 data (837, 835 and 834)
Technical knowledge and leadership skills in the areas of modern software development, production support, vendor management, and to successfully drive implementation of modern architecture
Sound knowledge of systems and operations
Expert knowledge of managing and leading Agile teams
Knowledge of software engineering and design
Knowledge of the basic concepts of managed care
Skills and Abilities
Strong computer applications skills (Access, PowerPoint, Excel, Word, and Outlook) and comprehension of computer programming concepts and practices
Analytical and research skills
Skilled in communicating application or product or program effectiveness at all layers of an organization
Ability to manage and report on complex systems to internal and external leaders and partners
Ability to manage architectural direction and drive modernization of business-critical systems
Ability to lead and develop high performing team members, including hiring, goal setting, coaching, performance management, and development
Ability to effectively convey team goals and plans, ensuring integration into strategic plans and initiatives and understanding by other groups
Ability to build and maintain professional relationships with business, community, and internal management groups
Ability to delegate and coordinate tasks for multiple people and projects
Ability to manage the workloads of others and interact effectively and motivate staff to perform at their highest level
Ability to manage and effectively resolve conflict within and across teams
Ability to inspire and manage teams in support of continuous improvement related to complex, business critical systems
Ability to communicate effectively, both verbally and in writing, including strong presentation and change management skills
Ability to lead, plan and manage in ambiguous environments and with high degree of uncertainty
Ability to consistently handle multiple projects and meet established deadlines
Ability to make sound judgments as to how to prioritize work assignments
Ability to continuously learn new systems and tools and stay up to date on modern technologies and practices
Ability to keep up to date with technology and new releases of development tools
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
Ability to hear and speak clearly for at least 3-6 hours/day
Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.Equipment: General office equipment
Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used. #LI-Remote
#MULTI
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.
Veterans are strongly encouraged to apply.
We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.
Visa sponsorship is not available at this time.