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Monogram Health is seeking an experienced Director, IT Operations to run the day-to-day operation of our enterprise IT environment end-to-end. Reporting to the VP of Cloud Engineering, this leader is the operational counterpart to the VP's architectural and platform mandate: where the VP defines how our cloud and platform foundations are designed, the Director is accountable for how they run — alongside endpoint, identity, collaboration, network, and service management.

This is a hands-on operational leadership role for someone who blends classic IT service management discipline with modern Site Reliability Engineering practices. The Director ensures that core IT services, infrastructure, and platforms are reliable, secure, cost-effective, and demonstrably improving over time, measured by service levels, employee experience, and operational maturity, not just uptime.

This role partners closely with Cloud Engineering, Security, Applications, Data, and Business leaders, and is expected to operate as a peer-level technical leader who can push back constructively when operational realities require it. This position reports to the Vice President, Cloud Engineering.

The Director, IT Operations owns the operation of:

• Microsoft Azure environments (IaaS, PaaS, and supporting services) — operating to the architectural standards and platform patterns set by Cloud Engineering
• Enterprise networking — operating cloud networks, VPN, firewalls, and connectivity between on-premises, cloud, and remote users
• Identity & access — Microsoft Entra ID, conditional access, RBAC, and identity lifecycle
• Microsoft 365 services — Exchange Online, Teams, SharePoint, OneDrive
• Endpoint and user productivity platforms — device lifecycle, patching, and support
• IT service management — incident, problem, change, release, and request management
• Service monitoring, observability, and operational tooling across the IT estate

• Run end-to-end IT operations across cloud, network, identity, endpoint, and collaboration platforms
• Establish and operate Service Level Objectives (SLOs) and error budgets alongside traditional SLAs; use them to drive prioritization between reliability work and change velocity
• Lead incident response and major incident command for IT services; drive post-incident reviews and ensure systemic remediation
• Operate mature ITSM practices (incident, problem, change, release) and continuously evolve them — moving routine change toward automated, pipeline-driven flow while preserving controls
• Operate resilient compute, storage, networking, backup, and disaster recovery in Microsoft Azure to the standards set by Cloud Engineering
• Run cloud networking, VPN, firewall operations, and secure connectivity between on-premises, cloud, and remote users
• Own operational readiness for new systems, applications, and platform changes — including go/no-go authority for production cutover
• Operate Microsoft Entra ID, conditional access, and RBAC in partnership with Security; own identity hygiene and lifecycle execution
• Ensure reliable, performant delivery of Microsoft 365 services across the enterprise
• Improve the employee IT experience through automation, self-service, and modern workplace tooling; measure it with experience-level metrics (XLAs), not just ticket SLAs
• Ensure reliable IT connectivity and service delivery for corporate and clinical operations
• Promote and operationalize Infrastructure as Code (IaC) and configuration management in alignment with Cloud Engineering's standards
• Drive automation for provisioning, monitoring, patching, and routine operational tasks; measure and reduce manual toil
• Selectively adopt emerging automation and AI-assisted tooling where it materially improves reliability, response time, or employee experience
• Standardize platforms, reduce technical debt, and improve operational maturity over time
• Partner with Security to operationalize security controls, vulnerability management, and incident response
• Ensure IT operations meet HIPAA, HITRUST, and internal risk management requirements through evidenced, auditable practices
• Own operational evidence for audits — logging, access reviews, change records, and configuration baselines
• Drive FinOps practices across cloud and infrastructure platforms in partnership with Cloud Engineering
• Own the IT operations budget, forecasting, and vendor spend optimization
• Manage vendor and managed service provider relationships, including Microsoft
• Build, lead, and develop high-performing IT operations teams and managers; set career paths for operations engineers, SREs, and service managers
• Foster strong working relationships with Security, Applications, Data, and Business leadership
• Translate clinical and business needs into reliable, secure, well-operated IT services

• Minimum of seven (7) years in enterprise IT infrastructure and operations, including a minimum of three (3) years in an IT leadership role with production accountability
• Demonstrated experience operating Microsoft-centric environments at scale (Azure and Microsoft 365)
• Working knowledge of modern operational practices — SLOs, error budgets, postmortems, observability — layered onto a foundation of mature ITSM
• Track record of partnering with cloud architecture and platform engineering leaders
• Experience driving automation and reducing manual toil through IaC and operational tooling
• Proficiency with FinOps, vendor management, and managed service provider experience
• Prior experience in healthcare or other regulated environments (HIPAA/HITRUST a plus)
• Relevant Microsoft and/or ITSM certifications a plus

Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts

• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.