Vice President, Interoperability Strategy – Operations

Job not on LinkedIn

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $227.7k - $431.4k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Provide strategic and operational leadership for enterprise interoperability capabilities • Enable healthcare data to move securely and seamlessly between systems and organizations • Lead the enterprise interoperability strategy, roadmap, and operating model • Oversee secure, accurate, and timely data exchange between members, providers, health plans, and payer-to-payer capabilities • Ensure alignment with federal and state interoperability requirements • Translate regulatory changes into actionable business and technology plans • Partner with business, clinical, operational, and technology teams to improve data exchange across managed care workflows • Establish governance, performance measures, and risk controls • Lead partnership management for EHR and third-party integrators including Epic, Oracle, and Athena • Build and maintain relationships with providers, vendors, delegated entities, and external partners • Lead, coach, and develop high-performing teams • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Bachelor's Degree in healthcare administration, business, information technology, informatics, or related field required • 10+ years progressive leadership experience in healthcare interoperability, managed care operations, payer technology or related functions required • 5+ experience leading enterprise interoperability strategy and execution within a payer or managed care environment • 5+ strong knowledge of interoperability standards and requirements, including FHIR, HL7, EDI, and applicable CMS regulations • 5+ experience with core managed care workflows such as claims, utilization management, provider data, clinical data exchange, and prior authorization • 5+ demonstrated ability to influence across functions, communicate effectively with senior leaders, and drive results in a complex organization • Equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity