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As Project Manager, Data Operations, you're the connective tissue between external partners, account teams, and the internal teams doing the technical work. You keep EDI implementations on track from requirements through go-live and beyond. This role sits at the intersection of technical depth and client-facing execution — and getting it right directly protects the data integrity that our health plan partners and their members depend on.
Job Responsibility:
Manage implementations end-to-end: Own project delivery for inbound and outbound data feeds — 834, 837, COB, accumulator files, and proprietary eligibility and claims EDI processes
Configure and validate EDI connections
Define and document requirements
Navigate benefits changes
Keep stakeholders informed
Identify and clear blockers
Improve how data operations runs
Requirements:
B.S. or M.S. in Healthcare Administration, Project Management, or a relevant equivalent
5–9 years of experience in a Business Analyst, Project Manager, Implementation Manager, Engineer, EDI Specialist, or related medical insurance role
Experience with ANSI 5010 transactions including 837, 835, 834, and 270/271
Background in the healthcare or TPA industry preferred
Proficiency in JIRA and Confluence
Intermediate to advanced proficiency in Microsoft Office Suite, particularly Excel
Working knowledge of data analysis tools such as SQL, Tableau, Power BI, or comparable platforms
Demonstrated experience developing and maintaining EDI documentation and file specifications
Familiarity with File Transfer protocols and EDI processes including eligibility, claims, and accumulators
Nice to have:
Background in the healthcare or TPA industry preferred