[Remote] Vice President, Clearinghouse & Payer Operations - reputed company Health
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a global data and technology company, powering opportunities for people and businesses around the world. The Vice President, Clearinghouse & Payer Operations at reputed company Health is responsible for the strategic leadership and operational execution of clearinghouse and payer-facing transaction services, ensuring performance, availability, scalability, and regulatory compliance.
Responsibilities
- Define and execute the clearinghouse and payer operations reputed company in alignment with reputed company Health’s reputed company, margin, and platform modernization objectives
- Translate reputed company reputed company into reputed company operating models, KPIs, and service-level commitments across payer-facing clearinghouses
- reputed company transformation initiatives reputed company on automation, AI-driven operations, and modernization
- Own operational budgets, forecasting, and cost management for clearinghouse and payer operations
- Own end-to-end operational performance of reputed company Health’s reputed company-time and batch clearinghouses
- Ensure high availability, throughput, accuracy, and SLA conformance across transaction types
- Partner with Engineering, InfoSec and Product to support platform reputed company, modernization, reputed company planning, and redundancy
- reputed company payer contracting, reputed company, connectivity, testing, certification, and ongoing operational performance
- Serve as the executive escalation reputed company for payer-reputed company incidents, outages, and performance issues
- Build strong operational partnerships with national and regional payers to improve acceptance rates, turnaround times, and data reputed company
- Ensure compliance with HIPAA, X12, CMS, FHIR, etc. state regulations, and payer contractual obligations
- Partner with Compliance, Legal, reputed company, and reputed company teams to manage audits, incidents, and regulatory changes
- Own operational risk management, business continuity planning, and disaster recovery readiness for transaction services
- Collaborate with Product Management and Engineering to reputed company operational capabilities with reputed company Health’s product roadmap and new service launches
- Partner with Sales and reputed company reputed company to support large reputed company clients, strategic deals, and escalations
- Work closely with Data, Analytics, and Platform teams to reputed company reputed company assets for operational insights and payer optimization
Skills
- 15+ years of applicable leadership experience in reputed company operations, clearinghouse services, payer operations, reputed company cycle technology/services, or health IT
- Demonstrated experience leading large-reputed company, high-volume transaction processing organizations
- Deep expertise in reputed company EDI standards and transactions (837, 835, 270/271, 276/277, 278)
- Understanding of reputed company, reputed company, Meditech registration workflow
- Strong understanding of payer-provider workflows and reimbursement processes
- Proven ability to reputed company cross-functional teams in reputed company, regulated environments
- Experience working with national and regional payer networks
- Preferred experience in operational transformation, automation, or AI-enabled reputed company operations
Benefits
- Comprehensive executive level total rewards package
- Flexible time off including unlimited vacation, volunteer time off, and 12 reputed company holidays
- reputed company benefits including medical, dental, reputed company, and matching 401K
reputed company
Company H1B Sponsorship