Director, Applications - Claims Processing
Core
Lead the applications portfolio supporting complex healthcare claims processing, adjudication, reimbursement, and payment integrity operations.
Role type
Senior technology leadership (Director)
Builds
Cloud-native solutions for claims, authorization, workflow, and regulatory programs
Domain
Healthcare / Insurance / Claims Processing
Required skills
Azure cloud architecture, .NET development, AI-assisted development, low-code platforms (Pega, Salesforce), enterprise QA automation, healthcare payer operations, Trizetto QNXT, team leadership
Preferred skills
Managed care industry experience, HIPAA compliance, vendor management
Technologies
Microsoft Azure, Visual Studio, GitHub Copilot, Azure AI, Pega, Salesforce, Sitecore, Trizetto QNXT, AKS, Azure SQL, Data Factory, Synapse, Azure DevOps
Responsibilities
Lead custom-solutions portfolio for adjudication and payment integrity; Govern solution intake and lifecycle management; Partner with business stakeholders to translate needs into scalable solutions; Lead and develop engineering teams; Champion AI-first development practices; Drive cloud-native architecture and DevOps; Oversee application implementations and support; Drive strategic integrations with low-code platforms; Lead architecture reviews ensuring compliance with security and healthcare standards; Monitor application stability and performance; Manage strategic vendor relationships; Establish KPIs for operational efficiency; Gather requirements and develop technical designs; Participate in hands-on software development; Coordinate cross-functional projects and budgeting; Hire, mentor, and develop engineering organization