Edi Matrix

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
• Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
• Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
• Onsite: daily onsite requirement based on the essential functions of the job
• Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This position is Hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

Purpose of the Job

Manages the activities that focus on platform stewardship, operational excellence, and continuous service improvement within the Trading Partner Data Management (TPDM) organization. Owns the Edifecs EDI platform health, governance, and vendor relationship — including monitoring and alerting, SLA/KPI management, license tracking and management, capacity management, technical debt management, and any discipline that drives operational maturity and prevents outages.

Serves as the cross-pillar operational excellence leader within TPDM, absorbing complexity that spans the EDI, ETL, and Delivery pillars; owning the TPDM Intake & Triage process; and driving strategic initiatives to completion. Establishes and maintains TPDM operational metrics, scorecards, and reporting dashboards. Champions documentation governance and continuous service improvement across the TPDM Confluence environment and operational processes.

Provides mentorship, coaching, and career development support across the TPDM team, leveraging the established TPDM skill matrix and individual development planning frameworks. Will be a point of contact for cross-pillar escalations and operational decisions. Works with BCBSAZ management, IT leadership, business areas, and external vendor partners (including Edifecs) to ensure alignment of TPDM objectives with broader enterprise goals.

Required Qualifications Required Work Experience

Manager – Required Work Experience

• 3 years of experience with data integration, EDI transactions, or platform operations
• 3 years of project management experience
• 2 years of experience with demonstrated leadership responsibilities in a lead or supervisory role

Senior Manager – Required Work Experience

• 5 years of management experience
• 5 years of experience with demonstrated leadership responsibilities in a lead or supervisory role
• 3 years of experience with data integration, EDI transactions, and platform operations
• 3 years of project management experience
• 3 years of experience working in healthcare-related systems as a systems analyst, programmer, or operations leader

Required Education

• High-School Diploma or GED in general field of study

Required Licenses

• N/A

Required Certifications

• N/A

Preferred Qualifications Preferred Work Experience

• Experience with the Edifecs platform (EDI Gateway, SmartTrading, Transaction Manager) or equivalent enterprise EDI infrastructure
• Healthcare payer or provider IT environment experience – familiarity with X12 EDI transactions (837, 835, 270/271, 277, 278, 834)
• Vendor relationship management – experience owning SaaS or platform vendor relationships, including SLA negotiation and roadmap alignment
• Operational maturity frameworks – familiarity with ITIL, service management, or equivalent disciplines
• Documentation governance – experience standardizing technical and operational documentation across distributed teams (Confluence preferred)
• Process improvement methodology – Lean, Six Sigma, or equivalent continuous improvement experience
• 7 years of project management experience
• 3 years of management or supervisory experience, preferably within a large-scale, complex, IT organization

Preferred Education

• Master’s Degree in business, computer science or related field

Preferred Licenses

• N/A

Preferred Certifications

• Product Owner Certification
• Agile practitioner certification
• ITIL Foundation or higher
• Lean / Six Sigma certification
• Technical certifications in EDI, data integration, or reporting

Essential Job Functions and Responsibilities Manager – General

• Manage the activities, processes, and continuous improvement of the TPDM platforms and operational excellence functions. Ensure that the team complies with change control guidelines and operational standards.
• Coordinate with the EDI, ETL, and Delivery pillar leads on cross-pillar initiatives, escalations, and operational priorities. Serve as a cross-pillar resource and integrative leader, not a supervisor of the pillar leads.
• Provide direction and resources to deliver platform health, operational excellence, and strategic execution outcomes effectively.
• Provide clear and concise communication keeping stakeholders informed and escalating issues to senior leadership timely to minimize disruption.
• Give presentations, organize operating reviews, and conduct platform scorecard discussions with audiences ranging from technical teams to executive leadership.
• Develop a culture of trust, accountability, teamwork, high quality results, and continuous service improvement.
• Demonstrate leadership abilities along with good judgment and decision-making skills.
• Mentor and coach TPDM team members across all three pillars. Hold team members accountable for adhering to corporate policies and procedures.

Senior Manager – General

• Coach other leaders on the TPDM team, including pillar leads, on operational excellence disciplines.
• Manage multiple concurrent strategic initiatives, platform improvement programs, and operational deliverables.
• Plan, build, and run cross-pillar operational programs that span the EDI, ETL, and Delivery functions.
• Communicate proficiently with senior leaders, including Staff VP and executive stakeholders. Represent TPDM in cross-functional governance forums when delegated by the Director.
• Overcome blockers and deliver objectives creatively and strategically.
• Demonstrate readiness to cover Director responsibilities during absence as succession trajectory progresses.
• Own and maintain the Edifecs platform performance assurance scorecard, track uptime, throughput, error rates, SLA adherence, and integration performance across all trading partners.
• Establish, document, and enforce Edifecs platform standards – configuration governance, change management procedures, environment controls, and platform-level run and build books.
• Drive capacity management and technical debt management for the Edifecs platform – anticipating downstream technical needs and preventing capacity-driven outages.
• Serve as primary BCBSAZ point of contact for the Edifecs vendor relationship – managing escalations, roadmap alignment sessions, license tracking and management, and contract milestones at the operational level.
• Lead platform governance decisions – approval thresholds, rollback procedures, and patching / upgrade discipline.
• Monitor and report on the Edifecs SaaS migration implementation status, TCO realization, and milestone completion against the approved business case.
• Own the TPDM Intake & Triage process – maintain the framework, improve the intake workflow, and report on intake volume and resolution trends.
• Serve as the first escalation path for cross-pillar operational issues, absorbing decisions that would otherwise route to the Director.
• Drive continuous service improvement across the EDI, ETL, and Delivery pillars – identify friction, standardize workflows, and apply disciplines that drive operational maturity and prevent outages.
• Build and maintain TPDM operational metrics, scorecards, and reporting dashboards – providing leadership with timely visibility into organizational health, trading partner status, and performance against goals.
• Identify, scope, and partner with technical teams to implement automation opportunities that reduce manual effort and improve reliability.
• Maintain documentation governance across the TPDM Confluence environment – ensuring accuracy and currency of run books, build books, and partner documentation against established standards.
• Serve as the Director's operational counterpart – translating strategic vision into executable plans and maintaining momentum on initiatives between cycles of strategic attention.
• Drive the TPDM career development program – maintaining the skill matrix, facilitating individual development plan conversations, and identifying training pathways for team members.
• Lead and advance TPDM governance frameworks – including the Trading Partner File Integration Governance, build governance standards, and quality assurance processes.
• Own staffing plan documentation – maintaining organizational design artifacts, succession maps, and headcount justification materials.
• Champion documentation best practices across the organization – setting the standard for how TPDM produces, maintains, and retires documentation assets.
• Partner with the Director on external stakeholder engagement – including governance committee relationships, cross-departmental partnerships, and vendor coordination.

Operations

• Oversee day-to-day cross-pillar operational administration by coaching and motivating departmental personnel to make maximum use of experience and skills.
• Develop staff, including development and maintenance of training materials, establishing performance goals, regular follow-up with staff, and year-end performance evaluation support.
• Maintain effective working relationships to ensure teamwork in achieving corporate goals.
• Ensure service level agreements are established, monitored, and managed effectively; identify, prioritize, and resolve issues with business areas and vendors.
• Monitor quality performance, develop and maintain effective workflows, and seek to maximize system efficiencies.
• Review relevant production and operating policies to ensure the most efficient processes are in place and determine tactical plans to improve processes and services.
• Participate with management in formulating goals for the team. Participate in budgeting process, including resource capacity planning.

Strategy

• Participate in developing technical strategy to scale and standardize Trading Partner data management and platform operations.
• Establish and meet short- and long-term department goals in accordance with overall company objectives and divisional strategic planning.
• Assist in identifying gaps, mitigating issues, and developing alternative solutions for plans in play.
• Partner with other technology leaders to identify points of leverage, integration, and resource sharing.

Project Management

• Develop timelines, work estimates, and cost projections; manage projects to approved guidelines; review and consult on design and technical approach to ensure consistency.
• Provide analytical, process-driven team support and planning for IT projects and initiatives.
• Ensure change management protocols maximize benefit and alleviate unnecessary disruption.

Financial

• Manage use of corporate funds including budgeting, financial management, and reporting within designated authority.
• Identify opportunities to achieve administrative efficiencies while maintaining service.
• Support vendor negotiations to contain or reduce contract services expense and/or one-time purchase expense, in partnership with the Director.

Other

• The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
• Position may require evening, weekend, or on-call schedules, depending on project requirements, vendor escalations, or platform status.
• Perform all other duties as assigned.

Required Competencies Required Job Skills

• Intermediate skill in use of office equipment, including copiers, fax machines, scanners, and telephones
• Intermediate PC proficiency
• Intermediate proficiency in spreadsheet, database, and word processing software
• Advanced technical understanding of EDI platforms, data integration architectures, and trading partner integration patterns
• Advanced knowledge of monitoring platforms, alerting frameworks, and operational metrics design
• Working knowledge of vendor management, SLA administration, and license / contract tracking
• Experience working with high-volume, transactional, large-capacity systems in a 24x7 environment
• Ability to write reviews and provide constructive feedback to team members
• Ability to coach and mentor associates across multiple functional areas
• Proficient with Agile practices and operational serv