Staff VP Provider Data Solutions

Elevance Health • Tampa, FL

3d • $190,400 - $342,720 • Hybrid

About The Position

The Staff VP, Provider Data Solutions owns a portfolio of transformational projects and sets priorities for core provider data systems and platforms across all lines of business. The role bridges business and technology, leading modernization, automation, system implementation, business architecture, provider lifecycle platforms, contract digitization, data consumption, network intelligence, and pricing technology. It also owns government-programs policy and rules and a provider data quality program that translates policy and regulatory changes into reimbursement requirements, fee-schedule specifications, business rules, data controls, monitoring, and issue detection.

The position sets the multi-year operations, technology, and solutions roadmap; leads portfolio delivery and product management; and drives end-to-end operational improvement using Lean and Six Sigma, automation, and AI. It is accountable for provider data architecture and governance, regulatory compliance, vendor oversight, financial and performance goals, risk management, and organizational leadership. The role works closely with regional provider operations, business units, technology, government programs, legal, compliance, benefits, finance, and third-party vendors. The position requires travel as needed and is hybrid, with associates required to work in-office three days per week for this role.

Requirements

• Bachelor’s degree in a related field (BA/BS) and at least 10 years of experience at an executive director or above level with significant large-scale project management, strategic planning, and continuous improvement in the healthcare industry; or an equivalent combination of education and experience.
• Ability to travel.
• Demonstrated success prioritizing and managing a large portfolio of data-management or technology initiatives for core operational systems and platforms in a highly matrixed healthcare organization.
• Experience leading transformation and complex cross-functional partnerships spanning operations, technology, government programs, legal, compliance, benefits, and third-party vendors.
• Proven ability to deliver enhancements and implementations on time and within budget, including communications, scheduling, and user training.
• Experience hiring, developing, and leading a large team of operational and program staff, including leaders of leaders.
• Strong understanding of how provider data enables claims and pricing accuracy, directory integrity, provider and member experience, network performance, compliance, and analytics.

Responsibilities

• Set the multi-year roadmap for core provider data platforms, sequencing modernization, automation, and retirement decisions against strategy, regulatory mandates, and affordability goals.
• Lead issue management and impact analysis across solutions and benefits operations, developing clear decisions and accountable resolution plans.
• Prioritize and manage a large portfolio of provider data initiatives, including provider lifecycle platforms, roster automation, digital rules, data quality, contract digitization, pricing technology, and network intelligence.
• Own product management for the provider data portfolio, including requirements, design decisions, release planning, adoption, and benefit realization.
• Introduce automation and AI capabilities into operations with appropriate governance, controls, and measurable outcomes.
• Lead enterprise-wide improvement using Lean and Six Sigma to improve efficiency, quality, cycle time, and user experience.
• Own the end-to-end “contract to accurate payment” journey in partnership with operations, business units, technology, and compliance.
• Coordinate transformation changes with operational workflows, change management, communications, adoption standards, and technology changes.
• Drive simplification, standardization, automation, productivity, and cost efficiency across the provider lifecycle and operating expenses, including a 10% year-over-year expense reduction.
• Deliver initiatives on time and within budget through intake, prioritization, resourcing, milestone management, and executive reporting.
• Oversee migrations, integrations, acquisitions, and market launches that affect provider data.
• Own enterprise provider data models, definitions, standards, and integration architecture.
• Translate government-programs policy and regulatory changes into reimbursement requirements, fee-schedule specifications, business rules, and data controls, with implementation traceability and ongoing monitoring.
• Maintain compliance with enterprise strategy and regulatory requirements, including CMS, state Medicaid, NCQA, interoperability, and association obligations affecting provider data, directories, and pricing configuration.
• Strengthen functionality, data efficiency, and quality through issue detection, automated controls, validation, monitoring, and root-cause remediation.
• Govern AI and automation using a govern–map–measure–manage framework aligned with recognized industry standards, and oversee third-party and continuity risks for critical provider data pipelines.
• Build and sustain partnerships with regional provider operations, business units, operations, legal, compliance, benefits, finance, and vendors.
• Partner with enterprise technology and digital leaders on architecture decisions, delivery capacity, release management, and platform investment.
• Engage health-plan and market leaders to ensure solutions support growth, affordability, network strategy, client commitments, and market-specific needs.
• Manage vendor and third-party relationships, including contracting, performance oversight, concentration risk, and continuity planning.
• Represent provider data governance in executive forums, architecture and change-governance committees, regulatory discussions, and transformation initiatives.
• Communicate with executive presence to P&L owners, regulators, providers, compliance, audit, HR, and enterprise partners to align strategy, operations, risk resolution, and business impact.
• Deliver financial goals, productivity commitments, quality targets, service-level expectations, and regulatory performance for the portfolio.
• Manage the technology, solutions, and governance share of a nine-figure operating budget, including run, change, and vendor spend.
• Coordinate budget planning, investment prioritization, business-case development, and resource allocation.
• Build scorecards and executive reporting to track portfolio health, delivery, automation benefits, data quality, and compliance results.
• Identify, communicate, mitigate, and govern operational, technology, data, AI, third-party, and regulatory risks through enterprise channels.
• Hire, develop, and lead a sizable team across product, platform, automation, architecture, and policy-translation disciplines, including directors and senior individual-contributor leaders.
• Build organizational capability in portfolio ownership, business architecture, automation and AI, data governance, regulatory translation, and program delivery.
• Coach and develop leaders and strengthen performance, engagement, and succession depth across a multi-site onshore, offshore, and vendor workforce.
• Create a culture of accountability, innovation, quality, continuous improvement, and collaboration, and align workforce planning and change management to current and future needs.
• Travel as needed.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase plan
• 401(k) contribution and matching
• Merit increases
• Paid holidays
• Paid time off
• Incentive bonus programs
• Medical insurance
• Dental insurance
• Vision insurance
• Short- and long-term disability benefits
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Executive