AVP - Technology Lead
Business area
HPHS BPAAS
Role type
Full-time
Domain
Healthcare Payer
Job Summary
We are seeking a AVP Program Lead, Technology to drive and oversee large-scale technology programs within the healthcare payer industry. This leadership role will be responsible for strategic planning, execution, and governance of technology initiatives supporting claims processing, provider network management, member engagement, data interoperability, and regulatory compliance. The ideal candidate will have a deep understanding of healthcare payer systems, IT modernization, and digital transformation, ensuring alignment with business goals while delivering innovative solutions.
Key Responsibilities
Technology Program Leadership:
Lead enterprise-wide technology programs for healthcare payer operations, including core administration systems (Facets, QNXT, HealthEdge), cloud migrations, AI/automation, and interoperability initiatives.
Develop and implement technology roadmaps, governance frameworks, and execution strategies to support business transformation.
Drive agile, waterfall, or hybrid delivery models to execute large-scale IT programs efficiently.
Ensure alignment of technology initiatives with business goals, compliance requirements (HIPAA, CMS, NCQA), and member/provider needs.
Stakeholder & Cross-Functional Collaboration:
Partner with business leaders, IT teams, vendors, and external regulatory agencies to ensure seamless execution of technology programs.
Work closely with health plan executives, product owners, and operations leaders to understand strategic priorities and translate them into technology solutions.
Establish strong relationships with vendors, system integrators, and cloud providers (AWS, Azure, Google Cloud) to optimize technology investments.
Technology Innovation & Digital Transformation:
Lead AI, automation, and machine learning initiatives to improve payer operations, claims adjudication, and member engagement.
Implement FHIR-based interoperability solutions, data analytics platforms, and value-based care technology enhancements.
Oversee cybersecurity, data privacy, and compliance initiatives to mitigate risks and enhance security frameworks.
Program Governance & Performance Management:
Develop KPIs, OKRs, and performance metrics to track program success and report progress to senior leadership.
Identify risks, dependencies, and budget constraints, ensuring proactive mitigation strategies.
Manage a team of program managers, project managers, and IT leads, driving accountability and performance excellence.
Qualifications & Requirements
Education & Experience:
Bachelors degree in Computer Science, Information Systems, Healthcare Administration, or a related field (Masters preferred).
10+ years of experience in technology program management within the healthcare payer industry.
5+ years in a leadership role managing enterprise-wide healthcare IT initiatives.
Skills & Competencies:
Strong knowledge of healthcare payer technology ecosystems, including claims processing, member enrollment, provider networks, and regulatory compliance.
Expertise in enterprise architecture, cloud computing, AI/automation, and healthcare interoperability (FHIR, HL7, EDI 837/835, APIs).
Experience with technology modernization, platform migrations, and digital transformation initiatives.
Proficiency in project/program management frameworks (Agile, SAFe, PMP, ITIL, Six Sigma).
Strong leadership, stakeholder management, and executive communication skills.
Preferred Qualifications:
PMP, SAFe Agile, ITIL, or Six Sigma certification.
Experience with EHR/EMR integrations, data lake implementations, and real-time analytics.
Familiarity with CMS, NCQA, and state Medicaid regulations
Date Posted: 06 April 2025
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