Vice President, Interoperability Strategy and Operations

Centene Management Company LLC; United States; Hybrid; USD 228,000 - 431,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work arrangements

Job summary

Centene Management Company LLC is seeking a senior leader to drive enterprise interoperability, enabling secure, seamless data exchange across members, providers, and payers. You will shape strategy, governance, and execution across all lines of business.

You will partner with clinical, operational, and tech teams to implement standards (FHIR/HL7/EDI), manage payer workflows, and ensure regulatory readiness. Strong leadership and cross-functional influence are essential.

Qualifications

• Bachelor’s degree in a related field is required.
• 10+ years progressive leadership experience in healthcare interoperability, managed care operations, payer technology or related functions.
• 5+ years leading enterprise interoperability strategy and execution within a payer or managed care environment.
• 5+ knowledge of interoperability standards including FHIR, HL7, EDI and CMS regulations.
• 5+ experience with core managed care workflows such as claims, utilization management, provider data, clinical data exchange, and prior authorization.

Responsibilities

• Lead the enterprise interoperability strategy, roadmap, and operating model to enable seamless data exchange across the enterprise.
• Oversee interoperability solutions for secure, accurate, timely data exchange among members, providers, health plans and payers.
• Ensure alignment with federal and state interoperability requirements and translate regulations into actionable plans.
• Collaborate across lines of business to improve data exchange in core managed care workflows.
• Establish governance, performance measures, and risk controls to support delivery and improvement.
• Lead partnerships with EHRs and third-party integrators (Epic, Oracle, Athena) to enable bidirectional communication.
• Build strategic relationships with providers, vendors, and external partners.
• Lead, coach, and develop high-performing teams with accountability and results.

Education

Bachelor’s Degree in healthcare administration, business, information technology, informatics, or related field

Tools

FHIR

HL7

EDI

CMS regulations

Job 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 senior leaders, and drive results in a complex organization.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range: $227,700.00 - $431,400.00 per year

At Centene, we connect people to the care they need to live healthier lives and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act