Senior Director of Information Technology Core Systems Operations

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The Senior Director of IT Core Systems is responsible for evaluating operational processes and procedures for process improvement of MetroPlusHealth Core Applications. This position will work with our application vendors as well as Claims Operations, Utilization Management, Network Management, and other operational areas to optimize the use of core systems supported by IT.

Work Shifts

9 : 00 A.M – 5 : 00 P.M

Duties & Responsibilities

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 set up system edits 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 10 years’ systems / operations management-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

#LI-Hybrid

#MPH50

Benefits

NYC Health and Hospitals offers a competitive benefits package that includes :

Comprehensive Health Benefits for employees hired to work 20+ hrs. per week

Retirement Savings and Pension Plans

Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts

Loan Forgiveness Programs for eligible employees

College tuition discounts and professional development opportunities

College Savings Program

Union Benefits for eligible titles

Multiple employee discounts programs

Commuter Benefits Programs