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Centene

Runs government-backed health insurance plans

Interoperability Vice President - Interoperability Strategy and Operations

Business OperationsConfirmed live in the last 24 hours
Full-timeNorth Carolina, USA$227.7k - $431.4k /yrRemote

About the Job

Requirements

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

Responsibilities

  • 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 facilitate 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 and third-party integrators, such as Epic, Oracle, and Athena, to ensure seamless bidirectional communication, reduce administrative burden, and advance the 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.
  • Perform other duties as assigned.
  • Comply with all policies and standards.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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