Senior Manager Health Information Exchange

    • Irvine, CA

Position Description

The Senior Manager, HIE-EDI Solutions is accountable for assuring the effective oversight of the Monarch HealthCare HIE, Health Information Exchange and EDI, Electronic Data Interchange solutions and operations. This position works collaboratively within the EHR, Electronic Health Record and Information Services Departments in the provision of innovative, cost effective HIE and EDI programs and solutions.

Primary Responsibilities:

  • Provides day-to-day management and coordination of HIE and EDI operations and activities, including systems functions, interface configuration, quality standards, security/privacy and compliance requirements, implementation support, utilization analysis, including identifying and solving problems that delay the optimal function and achievement of deliverables and assistance in planning and implementing the architecture for HIE and EDI ongoing operations and expansion.
  • Develops strategies for the ongoing support and maintenance of the Monarch HealthCare HIE and EDI solutions including the development of feedback mechanisms from participants and end-users including the development of reporting tools, additionally, develops and presents the concept and content of the HIE program to internal and external stakeholders, in a cohesive, meaningful and professional manner
  • Provide management and development of staff that support HIE and EDI operations, including performance appraisals, monitoring and coaching each individual staff member and supporting the development of the HIE/EDI team within the context of the broader EHR and IT departments.
  • Oversee the quality of technical service provided to/from HIE's participants by external vendors, ensuring maximum system availability, performance and response to users' support requirements. Act as technical liaison to a variety of audiences and stakeholders, including vendor and HIE and EDI participants and users
  • Ensure project objectives are being achieved; maintain all project deliverables and responsibilities; prepare written reports, workflow analysis, and operational documentation, including thorough documentation of the HIE architecture solutions as required.
  • Responsible for effectively overseeing the HIE connectivity components including the clinical portal and the data interfaces with the various participants. Coordinate the troubleshooting of connectivity and interface issues to insure their correction.
  • Responsible for overseeing EDI, for 837 and 835 claim and encounter submissions working closely with business operations and other Monarch and health plan participants and users
  • Ensure project objectives are being achieved; maintain all project deliverables and responsibilities; prepare written reports, workflow analysis, and operational documentation, including thorough documentation of the HIE architecture solutions as required.
  • Responsible for effectively overseeing the HIE connectivity components including the clinical portal and the data interfaces with the various participants. Coordinate the troubleshooting of connectivity and interface issues to insure their correction.


You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
  • Bachelor of Arts/Science Degree in a field of study consistent with health care, I.T. or computer science, e.g., health care information systems, or management
  • 3+ years of experience in Health Information Exchange and interoperability
  • 3+ years of experience in EDI technical specifications and operations
  • 3+ years of experience in system administration as well as project management including all phases of SDLC
  • Demonstrates knowledge and understanding of the philosophy of interoperability standards, including experience with implementing, coding and/or supporting electronic health records systems or health information exchange programs
  • Proven ability to manage, persuade, encourage, motivate, mentor and monitor a team of staff with varied skills and abilities
  • Strong understanding of information systems principles and techniques of data gathering, analysis and project management
  • Ability to conform to shifting priorities and timelines through analytical and problem solving capabilities


Preferred Qualifications:
  • NextGen HIE MIRTH Results certification
  • Experience in an integrated health system or health environment


Monarch HealthCare® , is led by doctors who are committed to offering patients the most extensive choices and access to Orange County's leading physicians, hospitals, labs and urgent care centers. This allows patients to get the perfect care in support of their good health. Monarch HealthCare's independent, private-practice physicians are part of a coordinated network that works together to promote excellence in patient care.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Senior Manager, HIE-EDI Solutions, Irvine, CA, California


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