Staff VP Provider Data Solutions

Elevance Health • Indianapolis, IN

1d • Hybrid

About The Position

The Staff Vice President, Provider Data Solutions owns a portfolio of transformational projects that deliver a connected, end-to-end provider data experience across all lines of business. The role sets priorities and manages initiatives for core provider systems and platforms, partnering closely with regional provider operations, government programs, operations, legal, compliance, benefits, finance, technology, business units, and third-party vendors. Provider data platforms and standards support approximately 50 million members and 4 million providers and facilities across numerous markets and lines of business.

The position leads strategy, modernization, product management, implementation, and governance for provider data platforms and related capabilities, including provider lifecycle systems, roster automation, digital rules, data quality, contract digitization, pricing technology, and network intelligence. It owns enterprise provider data models, definitions, standards, integration architecture, and government-programs policy translation, including traceability from regulatory policy through reimbursement requirements, implementation, controls, and monitoring. The role also advances automation and AI, Lean and Six Sigma improvement, operational quality, and user experience while maintaining alignment with enterprise strategy and regulatory requirements.

The Staff VP is accountable for portfolio delivery, financial and performance goals, risk management, vendor oversight, and a nine-figure operating budget. The role hires, develops, and leads a sizable, multi-site team of directors and senior leaders across product, platform, automation, architecture, and policy-translation disciplines. The position requires travel as needed and follows a hybrid arrangement requiring in-office work three days per week; candidates must be within reasonable commuting distance of an Elevance Health office unless an accommodation is granted.

Requirements

• Bachelor’s degree in a related field and at least 10 years of experience at an executive director level or above, with significant large-scale project management, strategic planning, and continuous improvement experience in the healthcare industry; an equivalent combination of education and experience is acceptable.
• Ability to travel.
• Ability to lead enterprise-scale initiatives and work across a complex, highly regulated, matrixed organization.

Nice To Haves

• 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 operations, technology, and solutions 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, translating operational, regulatory, provider, and financial impacts into decisions and accountable resolution plans.
• Prioritize and manage a large portfolio of data-management initiatives spanning 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 measurable benefit realization.
• Introduce automation and AI, including roster automation, rules-engine capabilities, and data self-healing, with governance, controls, and measurable outcomes.
• Lead enterprise 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, partnering on turnaround time, claim-pend inventory, pricing accuracy, utilization management, find care, capitation, value-based contracts, and leakage.
• 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, with a 10% year-over-year expense-reduction goal.
• Deliver initiatives on time and on budget through disciplined intake, prioritization, resourcing, milestone management, and executive reporting.
• Be accountable for migrations, integrations, acquisitions, and market launches affecting provider data.
• Own enterprise provider data models, definitions, standards, and integration architecture as authoritative standards across platforms and consumers.
• Translate government-programs policy and regulatory changes into reimbursement requirements, fee-schedule specifications, business rules, and data controls, with traceability through implementation and monitoring.
• Maintain compliance with enterprise strategy and applicable 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, including third-party and continuity oversight for critical provider data pipelines and vendor concentration.
• Build and sustain partnerships with regional provider operations, business units, operations, legal, compliance, benefits, finance, and third-party 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 and engage P&L owners, regulators, providers, compliance, audit, HR, and enterprise partners to align strategy, operations, process, 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 across operational, program, and implementation needs.
• Influence medical cost management, claims and pricing accuracy, payment integrity, member access, and customer service through platform, rules, and data-quality outcomes.
• 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 appropriate 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 transformation portfolio ownership, business architecture, automation and AI enablement, data governance, regulatory translation, and program delivery.
• Coach and develop leaders to 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, aligning workforce planning and change management with current and future needs.
• Travel as needed.

Benefits

• Comprehensive benefits package, subject to eligibility requirements.
• Incentive and recognition programs.
• Equity stock purchase plan.
• 401(k) contribution.
• Merit increases.
• Paid holidays.
• Paid time off.
• Incentive bonus programs, unless covered by a collective bargaining agreement.
• Medical insurance.
• Dental insurance.
• Vision insurance.
• Short- and long-term disability benefits.
• 401(k) matching.
• Life insurance.
• Wellness programs.
• Financial education resources.

What This Job Offers

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