Vice President, Clearinghouse & Payer Operations

🕒 Yesterday

🇺🇸 United States – Remote

💵 $200k - $300k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

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Experian

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1996

🤖 Artificial Intelligence

🤝 B2B

☁️ SaaS

Artificial Intelligence • B2B • SaaS

Experian is a global leader in digital experience, technology, and transformation. They partner with recognized brands to enhance customer understanding, innovate product strategies, and implement agile technology solutions. With a focus on delivering superior customer experiences through AI, cloud architecture, and project management, Experian helps businesses streamline their operations and achieve their objectives effectively.

📋 Description

• Define and execute the clearinghouse and payer operations strategy in alignment with Experian Health's growth, margin, and platform modernization objectives • Translate enterprise strategy into scalable operating models, KPIs, and service-level commitments across payer-facing clearinghouses • Lead transformation initiatives focused on automation, AI-driven operations, and modernization • Own end-to-end operational performance of Experian Health's real-time and batch clearinghouses • Ensure high availability, throughput, accuracy, and SLA conformance across transaction types • Oversee payer contracting, onboarding, connectivity, testing, certification, and ongoing operational performance • Serve as the executive escalation point for payer-related incidents, outages, and performance issues • Ensure compliance with HIPAA, X12, CMS, FHIR, etc. state regulations, and payer contractual obligations

🎯 Requirements

• 15+ years of applicable leadership experience in healthcare operations, clearinghouse services, payer operations, revenue cycle technology/services, or health IT • Demonstrated experience leading large-scale, high-volume transaction processing organizations • Deep expertise in healthcare EDI standards and transactions (837, 835, 270/271, 276/277, 278) • Understanding of EPIC, Oracle, Meditech registration workflow • Strong understanding of payer-provider workflows and reimbursement processes • Proven ability to lead cross-functional teams in complex, regulated environments • Experience working with national and regional payer networks • Preferred experience in operational transformation, automation, or AI-enabled healthcare operations

🏖️ Benefits

• Comprehensive executive level total rewards package • Flexible time off including unlimited vacation, volunteer time off, and 12 paid holidays • Core benefits including medical, dental, vision, and matching 401K