Vice President, Interoperability Strategy and Operations

Description

• Position Purpose: Provides strategic and operational leadership for enterprise interoperability capabilities across the enterprise. Responsible for enabling healthcare data to move securely and seamlessly between systems, organizations, stakeholders including members, providers, payers and business partners. Leads the strategy, governance, development and execution of scalable, compliant data exchange solutions that support business performance, improved health outcomes, regulatory readiness, and a better experience for members and providers across all lines of business.

• Lead the enterprise interoperability strategy, roadmap, and operating model to enable seamless exchange and utilization of healthcare data across the enterprise.

• Oversee interoperability solutions that facilitates secure, accurate and timely data exchange between members, providers, health plans and payer-to-payer capabilities.

• Ensure alignment with federal and state interoperability requirements and translate regulatory changes into actionable business and technology plans.

• Partner across lines of business, clinical, operational, and technology teams to improve data exchange across core managed care workflows.

• Establish governance, performance measures, and risk controls to support effective delivery and continuous improvement.

• Lead partnership management for EHR & Third-Party Integrators (e.g., Epic, Oracle, Athena) to ensure seamless bidirectional communication, reduce administrative burden and advance Centene’s strategic roadmap.

• Build and maintain strategic relationships with providers, vendors, delegated entities, and external partners.

• Lead, coach, and develop high-performing teams while fostering accountability, collaboration, and results.

• Performs other duties as assigned.

• Complies with all policies and standards.

• Education/Experience: 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