Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Director of EDI & Inbound Claims Configuration

Molina Healthcare of Illinois

Molina Healthcare is seeking a senior product leadership professional to guide delivery of enterprise products across health plans and compliance workflows. This role directs teams, aligns backlog with business outcomes, and collaborates with engineering, architecture, and operations to ensure scalable, compliant solutions. Key responsibilities include shaping product vision, managing configuration and fee schedules, and driving improvements across critical health plan processes in a remote #J-18808-Ljbffr Molina Healthcare

Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Director of EDI & Inbound Claims Configuration in New York, NY vacancy
  • $136.19k - $170.24k

     ...confirmation, billing, returns, and customer claims. Design Oracle Fusion Order...  ...procedures. Partner with EDI and integration teams to support inbound OEM releases and outbound order acknowledgments...  ...design documents, process maps, configuration workbooks, test scenarios,... 
    EDI
    Claims
    Full time
    Temporary work
    Visa sponsorship
    Relocation package

    Fujitsu

    New York, NY
    2 days ago
  •  ...are seeking an experiencedQNXT Benefit Configuration Analystto support the implementation, enhancement...  ...payer operations, benefit plan design, claims processing, SQL, and end-to-end testing....  ...Claims, Enrollment, Provider, Finance, EDI, and Customer Service. Maintain... 
    EDI
    Claims

    Veriipro

    New York, NY
    5 days ago
  •  ...Systems Manager leads and oversees system configuration and maintenance activities within the...  ...This role is responsible for payer setup, EDI enrollment and management, file...  ...workflows to support efficient billing, claims processing, and cash flow. This role partners... 
    EDI
    Claims
    Contract work

    Thedermspecs

    New York, NY
    3 days ago
  • $105.4k - $207.8k

     ...when an agentic use case can be reused with light configuration, when it needs substantial extension, and when a client...  ...of healthcare data and data standards (e.g., claims, remittances, EMR data, HL7, FHIR, X12 EDI), with the ability to reason through data quality and... 
    EDI
    Claims
    Local area

    Deloitte

    New York, NY
    12 hours ago
  • $95k - $105k

     ...to streamline EPR compliance and make credible sustainability claims. At rePurpose, we believe a world free of plastic waste is achievable...  ...processes. Manage user permissions, field/property configuration, data hygiene, lifecycle stages, pipeline setup, and process documentation... 
    Claims
    Live in
    Work at office
    Remote work
    Flexible hours
    3 days per week

    United States Digital Space LLC

    New York, NY
    2 days ago
  •  ...Epic Payer Platform Lead who has personally configured or led configuration of EPP Capabilities...  ...support. Epic Tapestry certification in Claims, E&E, Benefits Engine, CRM, or UM -...  ...with Epic integration standards (FHIR R4, EDI X12, CDA/CCDA) as applied to EPP data exchange... 
    EDI
    Claims
    Full time
    Work experience placement
    Live in
    Work at office
    Local area

    Accenture

    New York, NY
    4 days ago
  • $96.8k - $121k

     ...systems with the industry's first Unified Claims Processing architecture, seamlessly...  ...problems Document data exchange processes, configurations, and troubleshooting steps Process...  ...~ Strong knowledge and familiarity with EDI SNIP validations and one of the most... 
    EDI
    Claims
    Work experience placement
    Work at office
    Local area
    Flexible hours
    3 days per week

    Capital Rx

    New York, NY
    5 days ago
  • $250k

     ...everything for our 28 million members. Position Purpose Oversee operations for multiple support functions, including configuration, claims support services, provider relations, call center and field operations. Perform duties as chief liaison between the business... 
    Claims
    Full time
    Part time
    Work at office
    Remote work
    Relocation
    Flexible hours

    Hong Kong Study Skills Research Institute

    New York, NY
    1 day ago
  • $144.8k - $181k

     ...systems with the industry's first Unified Claims Processing™ architecture, seamlessly...  ...analytics, stop-loss, client reporting, EDI/data feeds, and external vendors. Design...  ...operations, payer/TPA operations, claims configuration, provider relations, or healthcare data-... 
    EDI
    Claims
    Contract work
    Local area
    Flexible hours

    Capital Rx

    New York, NY
    5 days ago
  •  ...end lifecycle of DAM platform, from initial implementation and configuration through ongoing support and enhancement Serve as business...  ...including controlled vocabularies aligned to channels, audiences, claims, and customer journeys Ensure consistent metadata capture at asset... 
    Claims

    Jobtailor

    New York, NY
    1 day ago
  • $174.8k - $218.5k

     ...systems with the industry's first Unified Claims Processing architecture, seamlessly...  ...and technical readiness. Ensure network configurations align with business goals and client-specific...  ...healthcare data exchange standards (EDI transactions such as 837, 835, 270/271,... 
    EDI
    Claims
    Contract work
    Local area
    Flexible hours
    3 days per week

    Capital Rx

    New York, NY
    4 days ago
  •  .... Pharmacy management system selection, configuration, and integration with the EHR and 340B split...  ...duplicate-discount prevention; update claims identification and billing processes as...  ..., ideally including experience at the Director or Senior Director level within a health... 
    Claims
    Contract work

    Betances Health Center

    New York, NY
    1 day ago
  • $150.8k - $188.5k

    Data Exchange Manager - Claims Operations Judi Health is a health technology company providing benefit...  ...healthcare data integrations, client onboarding, EDI transactions, eligibility feeds, claims exchanges, configuration setup, data quality monitoring, and operational... 
    EDI
    Claims
    Local area
    Flexible hours

    Judi Health, LLC

    New York, NY
    2 days ago
  • $69.85k - $97.09k

     ...proactively assisting them with post‑sales installation, configuration, upgrade, troubleshooting and day‑to‑day operational...  ...determining financial impact. Analyze and reconcile claims and encounter data, including 837 EDI encounter files for EDPS, RAPS and Edge Server... 
    EDI
    Claims
    Local area
    Remote work

    LE1000 Veradigm LLC

    New York, NY
    5 days ago
  •  ...built guestrooms with a variety of bedding configurations including king, queen, double/double...  ...is responsible for assisting the Director of Human Resources with a variety of Human...  ...prescreening interviews. Respond to unemployment claims, maintain unemployment logbook.... 
    Claims
    Hourly pay

    Highgate Hotels

    New York, NY
    3 days ago
  • $195k - $215k

     ...product experience team. This role will shape how customers access, configure, manage, and scale on-platform Vidmob experiences. Our core...  ...number, or password, through email. If you receive an email claiming to be from Vidmob that does not come from a @ vidmob.com... 
    Claims
    Work at office

    Vidmob

    New York, NY
    5 days ago
  • $142.6k - $261.5k

     ...programs. A number of solution “hot spots” exist today, such as in claims, underwriting, policy and billing. Our ambition is to be the C...  ...of business and technology architectureApplication configuration/integrationData mapping, conversion, migrationAbility to deliver... 
    Claims
    Work experience placement
    Summer holiday
    Flexible hours

    EY (Ernst & Young)

    New York, NY
    4 days ago
  • $240k - $265k

     ...Summary OpenGov is looking for a Senior Director of HR Operations & Total Rewards to serve...  ...instant answers on coverage, costs, and claims. You should bring deep Workday...  ...integrity, and audits. You know how to configure Workday to run comp cycles cleanly, manage... 
    Claims
    Contract work
    Work experience placement
    Work at office
    Local area
    Flexible hours

    OpenGov Inc.

    New York, NY
    3 days ago
  •  ...Job Description WHAT DOES AN ASSOCIATE DIRECTOR, MEETING SERVICES DO? The Associate Director...  ...and execution plans. Support configuration and testing of bureau portals, workflows...  ...unsolicited e‑messages, or even text messages claiming to be a legitimate company. Some of... 
    Claims
    Work at office
    Local area
    Shift work
    Afternoon shift

    EVERSANA INTOUCH

    New York, NY
    3 days ago
  •  ...seeking a Senior Technical Implementation Manager to lead platform configurations, integrations, and technical implementation initiatives. This...  ...Configure platform setups, SFTP connections, and eligibility, claims, and prior authorization files. Manage QA of configurations... 
    Claims
    Immediate start
    Remote work
    Flexible hours

    Leap Health, Inc.

    New York, NY
    1 day ago
  •  ...solutions that support enrollment, claims, provider, member, care...  ...TriZetto Facets platform. Configure and develop Facets batch processes...  .... Build and maintain inbound and outbound data integrations...  ...healthcare data files including: o EDI 834 o EDI 835 o EDI 837 o EDI... 
    EDI
    Claims
    Full time
    Remote work

    PSRTEK

    New York, NY
    2 days ago
  • $85k - $110k

     ...applications, system infrastructure, network layer, and security configurations understanding of financial reporting processes including...  ..., cash management, revenue recognition, IT departments, loans/claims management Experience supervising Associates and Senior Associates... 
    Claims
    Flexible hours

    Weaver

    New York, NY
    4 days ago
  •  ...operations professional with deep expertise in EDI (Electronic Data Interchange), specifically HIPAA 834 Enrollment and 837 Claims transactions, to lead implementation efforts...  .... Oversee testing and validation of inbound and outbound EDI files to ensure compliance... 
    EDI
    Claims
    Temporary work
    Remote work

    Imagine360, LLC

    New York, NY
    3 days ago
  • $171.6k - $392.1k

     ...experiences emerging as the most critical "hot spot" alongside claims, underwriting, policy, and billing. Our ambition is to be the...  ...Advanced Product Designer, Authentication/Authorization, APIs, and configuration; ability to architect customized solutions that adapt into... 
    Claims
    Work experience placement
    Summer holiday
    Flexible hours

    EY

    New York, NY
    2 days ago
  • $75k - $95k

     ...performance using revenue, margin, service, claims, and operational KPIs. Identify...  ...(20%) Identify opportunities to increase inbound and outbound freight volume with existing...  ...organizations regarding interchange processes, EDI connectivity, POD management, service standards... 
    EDI
    Claims

    CrossCountry Freight Solutions

    New York, NY
    1 day ago
  •  ...Claims Business AnalystDuration-6 – 12 months ++Hybrid 3 Days a week: Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken,...  ...implementation – for each jurisdiction there's different compliance req edi calls; Verisk exp VERY HELPFUL, pbm, medical bill mngt, etd to... 
    EDI
    Claims
    3 days per week

    RIT Solutions

    New York, NY
    2 days ago
  • $174.8k - $218.5k

     ...systems with the industry's first Unified Claims Processing architecture, seamlessly...  ...timely, and compliant processing of HIPAA EDI transactions and hosted gateway solutions...  ...delays. Manage daily operational controls for inbound/outbound files, transaction queues,... 
    EDI
    Claims
    Local area
    Flexible hours

    Capital Rx

    New York, NY
    4 days ago
  •  ...their use of Stedi’s API-enabled clearinghouse, focusing on revenue cycle management and EDI-related workflows. You will work with customers to optimize eligibility checks, claims processing, and remittance reconciliation, while relaying insights back to product and engineering... 
    EDI
    Claims

    Stedi

    New York, NY
    4 days ago
  •  ...own the day-to-day revenue cycle for a set of customers, including claim submission, authorizations, payment posting, AR follow-up, and...  ...with multiple clearinghouses and payer portals Familiarity with EDI, eligibility verification, or verification of benefits workflows... 
    EDI
    Claims

    Ease Health

    New York, NY
    3 days ago
  • $168k - $285.6k

     ...Fortune Media IP Limited, used under license. Claim based on GitLab data. Fortune 100 refers...  ...GitLab. An overview of this role As the Director, Pipeline Excellence you'll help GitLab...  ...funnel conversion and velocity across inbound, outbound, partner, and expansion. In your... 
    Claims
    Full time
    Remote work
    Flexible hours

    Visa Hunt

    New York, NY
    5 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Director of EDI & Inbound Claims Configuration. Be the first to apply!