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Monogram Health, Inc.

Director IT Operations

brentwood, TN

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Job description

Description

Position: Director, IT Operations

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

Responsibilities

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

Position Requirements

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

About Monogram Health

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.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

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Worksite address

brentwood, TN, 37027, US

Who can apply

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