Vice President, Clearinghouse & Payer Operations - Experian Health

Google Chrome Microsoft Edge Apple Safari Mozilla Firefox Vice President, Clearinghouse & Payer Operations - Experian HealthFull-timeEmployee Status: RegularExecutive Salary Range: $200,000 - $300,000Role Type: HomeJob Posting - Salary Range: See belowDepartment: Customer ServiceFlexible Time Off: UnlimitedSchedule: Full TimeShift: Day Shift Compensation: USD 200000 - USD 300000 - yearlyCompany DescriptionExperian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets, from financial services to healthcare, automotive, agribusiness, insurance, and many more. Experian invests in people and new advanced technologies to unlock the power of data. We have an amazing team of 25,200 people in 32 countries.  Job DescriptionSmarter business decisions. A better bottom line. Stronger relationships with patients. That’s what healthcare organizations experience using Experian Health’s industry-leading solutions for revenue cycle management, identity management, patient engagement and care management.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. This role ensures the performance, availability, scalability, and regulatory compliance of mission-critical electronic data interchange transactions that connect providers, payers, and healthcare networks.Reporting to the Chief Client Officer, you will drive operational excellence across both real-time and batch clearinghouses, spanning claims, eligibility, remittance, prior authorization, and other payer connectivity services. You will leverage Experian’s data, analytics, and automation capabilities to enhance transaction efficiency, performance, contract adherence, and overall client outcomes.Key ResponsibilitiesStrategic & Operational LeadershipDefine and execute the clearinghouse and payer operations strategy in alignment with Experian Health’s growth, margin, and platform modernization objectivesTranslate enterprise strategy into scalable operating models, KPIs, and service-level commitments across payer-facing clearinghousesLead transformation initiatives focused on automation, AI-driven operations, and modernizationOwn operational budgets, forecasting, and cost management for clearinghouse and payer operationsClearinghouse OperationsOwn end-to-end operational performance of Experian Health’s real-time and batch clearinghousesEnsure high availability, throughput, accuracy, and SLA conformance across transaction typesPartner with Engineering, InfoSec and Product to support platform resilience, modernization, capacity planning, and redundancyPayer Network & RelationshipsOversee payer contracting, onboarding, connectivity, testing, certification, and ongoing operational performanceServe as the executive escalation point for payer-related incidents, outages, and performance issuesBuild strong operational partnerships with national and regional payers to improve acceptance rates, turnaround times, and data qualityCompliance, Risk & ReliabilityEnsure compliance with HIPAA, X12, CMS, FHIR, etc. state regulations, and payer contractual obligationsPartner with Compliance, Legal, Security, and Privacy teams to manage audits, incidents, and regulatory changesOwn operational risk management, business continuity planning, and disaster recovery readiness for transaction servicesCross-Functional LeadershipCollaborate with Product Management and Engineering to align operational capabilities with Experian Health’s product roadmap and new service launchesPartner with Sales and Client Success to support large enterprise clients, strategic deals, and escalationsWork closely with Data, Analytics, and Platform teams to leverage Experian assets for operational insights and payer optimizationQualifications15+ years of applicable leadership experience in...