Director of Software and Systems

Description

Verda Healthcare, Inc. is a Medicare Advantage Prescriptions Drug Plan (MAPD) organization committed to the idea that healthcare should be easily and equitably accessed by all, currently available in Texas and Arizona. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Director of Software and Systems to join our growing company with many internal opportunities.

Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.

Align your career goals with Verda Healthcare, Inc. and we will support you all the way.

Position Overview  

The Director of Software and Systems reports to the Chief Information Officer and leads Verda Healthcare’s enterprise application delivery, custom software engineering, electronic data interchange (EDI), systems integration, and software-as-a-service (SaaS) vendor management. This leader is accountable for the reliability, security, scalability, and business value of application solutions supporting health plan operations. The Director will partner with executive leadership, business process owners, IT infrastructure and security teams, and external vendors to implement a cohesive application strategy, modernize workflows, improve data interchange, and deliver measurable operating efficiencies. The role requires a leader who can establish technical direction and governance while remaining capable of engaging in hands-on architecture reviews, complex troubleshooting, vendor escalations, and delivery execution. The Director will also champion responsible adoption of artificial intelligence (AI) and automation across the organization.

Responsibilities:

Software Engineering and Application Delivery

· Lead the design, development, implementation, integration, and ongoing support of enterprise applications, databases, and business automation solutions.

· Oversee the software development lifecycle, establishing standards for architecture, secure coding, quality assurance, Agile methodologies, CI/CD, and release management.

· Direct cloud-based application development, primarily within Microsoft Azure, ensuring scalability, reliability, performance, and alignment with business requirements.

Healthcare EDI, Interoperability, and Data Exchange

· Oversee healthcare EDI operations, including data ingestion, transformation, transmission, reconciliation, monitoring, and issue resolution.

· Manage healthcare data exchanges, including X12 transactions (834, 837), HL7, FHIR, and integrations with CMS, providers, clearinghouses, and other trading partners.

· Ensure data accuracy, regulatory compliance, timely submissions, and resolution of EDI errors through effective controls, documentation, and process improvements.

SaaS Platforms and Vendor Management

· Direct the evaluation, implementation, integration, optimization, and lifecycle management of enterprise SaaS platforms and business applications.

· Manage technology vendors, contracts, licensing, service-level agreements, performance, and costs to ensure operational effectiveness and value.

AI, Automation, and Innovation

· Identify and implement AI, intelligent automation, and emerging technology solutions to improve operational efficiency, productivity, and member and provider experiences.

· Establish responsible AI implementation practices in collaboration with Security, Compliance, and Privacy teams, ensuring appropriate data protection, governance, and measurable business outcomes.

Application Strategy, Governance, and Compliance

· Develop and execute applications, EDI, and SaaS technology roadmaps aligned with the CIO's strategic priorities and organizational objectives.

· Ensure application architecture, integrations, and systems comply with HIPAA, CMS, cybersecurity, data privacy, and applicable regulatory requirements.

Leadership, Business Partnership, and Financial Management

· Lead, mentor, and develop software engineering, EDI, application support, and external technical resources, fostering accountability and continuous improvement.

· Partner with executive leadership and business stakeholders to identify technology needs, prioritize initiatives, and deliver solutions that support operational and strategic goals.

· Manage application-related projects, budgets, vendor expenditures, resource allocation, and performance metrics, providing regular reporting and recommendations to the CIO.

Preferred Qualifications 

· Experience working directly for a healthcare payer, health plan, managed care organization, or Medicare Advantage organization; experience with CMS-regulated operations strongly preferred.

· Successfully implementing AI, intelligent automation, or generative AI solutions in production with measurable business value and appropriate governance.

· Knowledge of Medicare Advantage workflows, such as enrollment, claims, encounter data, provider data, utilization management, and member services.

· Experience with Azure DevOps, Git, CI/CD, cloud application services, Microsoft SQL Server, Python, C#, JavaScript, and integration/ETL technologies.

· Familiarity with FHIR, HL7, APIs, secure file transfer, data governance, and application-level HIPAA controls.

· Master’s degree, MBA, or relevant cloud, engineering, project, or security certification.

Professional Competencies

· Strategic thinking and sound technical judgment; business partnership and executive communication

· Accountability and integrity

· People leadership and mentoring

· Analytical problem-solving and root-cause analysis

· Vendor negotiation and commercial judgment

· Adaptability and continuous improvement 

· Ability to balance speed, operational stability, and compliance.

Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!

Job Type: Full-time

Location: Huntington Beach, CA 

Compensation Range: $140,000-160,000

Benefits:

• 401(k)
• Paid time off (vacation, holiday, sick leave)
• Health insurance 
• Dental Insurance
• Vision insurance 
• Life insurance

Schedule:

• Full-time onsite (100% in-office)
• Hours of operations: 9am – 6pm
• Standard business hours Monday to Friday/weekends as needed
• Occasional travel may be required for meetings and training sessions.

Ability to commute/relocate:

• Reliably commute or planning to relocate before starting work (Required).

PHYSICAL DEMANDS

Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.

*Other duties may be assigned in support of departmental goals. 

Requirements

· Bachelor’s degree in Computer Science, Information Systems, Software Engineering, Information Technology, or related discipline, or equivalent combination of education and relevant experience.

· Minimum 10 years of progressive professional experience in software engineering, enterprise applications, systems integration, healthcare EDI, or related healthcare technology functions; 12+ years preferred.

· Demonstrated experience delivering technology solutions in healthcare, including knowledge of regulated data handling and operational workflows.

· At least 5 years of leadership or management experience directing technical personnel, cross-functional initiatives, or significant vendor-delivered programs.

· Demonstrated hands-on experience with cloud-based software development environments, including architecture, deployment, and delivery pipelines in Microsoft Azure, AWS, or equivalent; strong Microsoft Azure experience preferred.

· Proven experience managing the software development lifecycle, system integrations/APIs, relational databases and SQL, software quality, secure development practices, and production application support.

· Working knowledge of healthcare EDI standards and operational controls, including X12 transactions, partner file exchange, mapping, reconciliation, and exception resolution.

· Experience managing enterprise SaaS implementations, vendor performance, licensing, and contractual service commitments.