Director IT Operations

Monogram Health•Brentwood, TN

About The Position

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.

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

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