HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.

The Data Operations Lead (Onshore) is accountable for the end-to-end delivery, quality, and reliability of Enrollment data operations. Working in partnership with the offshore Data Operations team and its lead, this role owns operational outcomes, directly performs operational activities that must be executed during US business hours, and serves as the primary onshore point of contact for internal and external customers. This is an individual contributor role with no direct reports; it leads through expertise, ownership, and influence.

Responsibilities/Tasks

• Accountable for the timely, accurate, and compliant execution of all Enrollment production data and data exchange processes, whether performed onshore or by the offshore team.
• Executes and monitors operational activities that must be performed during US business hours, including time-sensitive, client-facing, or production-dependent tasks.
• Partners with the offshore Data Operations Lead, who sets day-to-day priorities for offshore analysts, to align on workload, schedules, risks, and completion of Daily, Weekly, Monthly, Quarterly, and Yearly activities.
• Serves as the escalation point for complex production issues; leads troubleshooting, root-cause analysis, and corrective and preventive actions.
• Owns, implements, and continuously improves standard operating procedures (SOPs) and runbooks, so that the offshore team can execute them independently; approves SOP changes.
• Reviews and validates critical processes and outputs to ensure quality, and drives remediation when issues recur.
• Understands Batch job design, scheduling, dependencies, and alerting for Enrollment operational processes; analyzes failures and orders jobs when the situation demands.
• Leads outage resolution and validation after weekend patching and rollover activities, coordinating with IT, infrastructure, and vendors.
• Leads communication of results and issues to internal and external customers and to management, per team standards.
• Ensures effective shift-to-shift handoffs between onshore and offshore teams, including status, open issues, and pending actions.
• Provides technical guidance, coaching, and knowledge transfer to offshore Data Operations team.
• Reports operational metrics, SLA performance, and risks to the Data Operations Manager.
• Participates in on-call rotation and after-hours work to support scheduled operational activities and escalated production incidents.
• Identifies and drives process improvement and automation opportunities.
• Supports projects and cross-functional teams to produce desired results.
• Develops and maintains effective working relationships with internal and external customers.

Decision Authority
Has authority to make operational decisions for Enrollment processes during routine operations and incidents, including approving SOP changes and determining escalation paths, within guidelines set by the Data Operations Manager.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
Employment Qualifications

Education
Bachelor’s degree in Business Administration, Economics, Health Care, Information Systems, Statistics, or a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification (such as ITIL) is highly preferred and encouraged.

Experience
Seven or more years of experience in a related field is required, including demonstrated ownership of production or operations processes. Experience in at least two of the following areas is preferred: health care operations, health care economics, health care policy, statistical modeling, business decisions, analysis, or business management. Experience in healthcare is highly preferred, as is experience with a healthcare claims or enrollment platform. Experience working with offshore or globally distributed teams is strongly preferred.

Skills/Knowledge/Abilities (SKA) Required

• Strong analytical, planning, problem-solving, verbal, and written skills to communicate complex ideas, including clear written communication for asynchronous coordination across time zones.
• Advanced SQL Server/Transact-SQL skills, with the ability to troubleshoot complex issues and guide others.
• Advanced expertise in jb scheduling tools like Control-M, including monitoring, analyzing failures, ordering jobs, and designing schedules and dependencies.
• Experience in the following technologies and willingness to work on other technologies: MS SQL, Oracle, Control-M.
• Proven ability to lead through influence without direct authority, and to partner effectively with an offshore lead and team.
• Strong ownership, accountability, and sound judgment in high-pressure production situations.
• Strong ability to work independently, within a team environment, and to communicate effectively with employees and clients at all levels.
• Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
• Availability outside standard business hours, including on-call and after-hours support based on the operational schedule, and flexibility for early or late calls with the offshore team.

Geographic Responsibility:  Remote, US

Type of Employment: Full-time, permanent 

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  

• The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  

• Work across multiple time zones in a hybrid or remote work environment. 

• Long periods of time sitting and/or standing in front of a computer using video technology. 

• May require travel dependent on company needs. 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. 

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**The annual US base salary range for this position is $120,000 to $135,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.