Full-Time Manager - Payer Operations

Reporting to Experian Health, the Manager – Payer Operations will lead a team of EDI Analysts responsible for optimizing connectivity monitoring and ensuring operational excellence across electronic transaction workflows.

The Manager will be an important escalation point, guide process improvements, and collaborate with all partners to ensure seamless payer integration and performance.

You will:

• Lead a team of EDI Analysts (Levels 1–3) assuring optimal performance and providing coaching for professional development.
• Oversee daily operations related to payer transaction monitoring, and issue resolution.
• Ensure identification, escalation, and resolution of EDI transaction errors and connectivity issues.
• Coordinate with external trading partners and company partners to resolve issues
• Guide the development of EDI documentation and process documentation.
• Help implement automation and AI technologies to improve operational efficiency.
• Monitor team workload and performance metrics, ensuring adherence to performance and service level expectations.
• Implement process improvements, including documentation standards, tooling enhancements, and cross-training plans.
• Represent the team in meetings and industry forums.
• Maintain an understanding of healthcare EDI standards (270/271, 835/837, 278, 275) and evolving industry requirements.

Education & Experience:

• Bachelor's degree in business, Computer Science, Healthcare Administration, or related field
• 5+ years of experience in healthcare EDI, payer operations, or revenue cycle management
• 2+ years of direct people management experience overseeing technical or operational teams
• Knowledge of X12 and HL7 transactions, including 27x, 83x, and 278.
• Familiarity with payer/provider enrollment processes, EDI protocols, and API/web capture methods.
• Proficiency in Salesforce, JIRA, Microsoft 365, and data analytics tools (especially Excel).
• Experience with Agile methodologies (Scrum, Kanban)

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