Note: The job is a remote job and is open to candidates in USA. Experian is a global data and technology company, powering opportunities for people and businesses around the world. The Vice President, Clearinghouse & Payer Operations at Experian 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 strategy in alignment with Experian Health’s growth, margin, and platform modernization objectives
- Translate enterprise strategy into scalable operating models, KPIs, and service-level commitments across payer-facing clearinghouses
- Lead transformation initiatives focused 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 Experian Health’s real-time and batch clearinghouses
- Ensure high availability, throughput, accuracy, and SLA conformance across transaction types
- Partner with Engineering, InfoSec and Product to support platform resilience, modernization, capacity planning, and redundancy
- Oversee payer contracting, onboarding, connectivity, testing, certification, and ongoing operational performance
- Serve as the executive escalation point for payer-related incidents, outages, and performance issues
- Build strong operational partnerships with national and regional payers to improve acceptance rates, turnaround times, and data quality
- Ensure compliance with HIPAA, X12, CMS, FHIR, etc. state regulations, and payer contractual obligations
- Partner with Compliance, Legal, Security, and Privacy 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 align operational capabilities with Experian Health’s product roadmap and new service launches
- Partner with Sales and Client Success to support large enterprise clients, strategic deals, and escalations
- Work closely with Data, Analytics, and Platform teams to leverage Experian assets for operational insights and payer optimization
Skills
- 15+ years of applicable leadership experience in healthcare operations, clearinghouse services, payer operations, revenue cycle technology/services, or health IT
- Demonstrated experience leading large-scale, high-volume transaction processing organizations
- Deep expertise in healthcare EDI standards and transactions (837, 835, 270/271, 276/277, 278)
- Understanding of EPIC, Oracle, Meditech registration workflow
- Strong understanding of payer-provider workflows and reimbursement processes
- Proven ability to lead cross-functional teams in complex, regulated environments
- Experience working with national and regional payer networks
- Preferred experience in operational transformation, automation, or AI-enabled healthcare operations
Benefits
- Comprehensive executive level total rewards package
- Flexible time off including unlimited vacation, volunteer time off, and 12 paid holidays
- Core benefits including medical, dental, vision, and matching 401K
Company Overview
Company H1B Sponsorship