Vice President, Clearinghouse & Payer Operations (Healthcare)

TL;DR

Vice President, Clearinghouse & Payer Operations (Healthcare): Leading strategic and operational execution of clearinghouse and payer-facing transaction services with an accent on electronic data interchange (EDI) performance, scalability, and regulatory compliance. Focus on driving operational excellence through automation, AI-driven modernization, and strengthening payer network relationships.

Location: Remote (United States)

Salary: $200,000 - $300,000

Company

Global data and technology company powering opportunities for people and businesses worldwide across various sectors including financial services and healthcare.

What you will do

• Define and execute the clearinghouse and payer operations strategy aligned with growth, margin, and platform modernization objectives.
• Manage end-to-end operational performance of real-time and batch clearinghouses ensuring high availability, throughput, and SLA conformance.
• Oversee payer contracting, onboarding, connectivity, testing, and certification across national and regional payer networks.
• Ensure strict compliance with HIPAA, X12, CMS, FHIR, and other state and payer contractual obligations.
• Lead transformation initiatives focused on automation, AI-driven operations, and modernization of transaction services.
• Collaborate with Product, Engineering, and Sales teams to align operational capabilities with the product roadmap and support strategic enterprise clients.

Requirements

• 15+ years of leadership experience in healthcare operations, clearinghouse services, payer operations, or health IT.
• Deep expertise in healthcare EDI standards and transactions (837, 835, 270/271, 276/277, 278).
• Proven experience leading large-scale, high-volume transaction processing organizations.
• Strong understanding of payer-provider workflows and reimbursement processes.
• Knowledge of EPIC, Oracle, and Meditech registration workflows.
• Must be based in the United States.

Nice to have

• Experience in operational transformation or AI-enabled healthcare operations.

Culture & Benefits

• Comprehensive executive-level total rewards package.
• Flexible time off, including unlimited vacation and 12 paid holidays.
• Core benefits including medical, dental, vision, and matching 401K.
• Inclusive, people-first, and purpose-driven culture recognized by Great Place To Work™.