Vice President, Business Operations Automation

Centene Corporation•Northampton, MA

About The Position

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. Position Purpose: Develops and executes the automation strategy across managed care operations. Drives large-scale transformation initiatives, leveraging advanced technologies to optimize processes, improves quality, and enhances employee, member and provider experiences. Collaborates with cross-functional teams, including business process owners, technology leaders, and clinical operations, to ensure automation aligns with organizational objectives and regulatory requirements. Sets the strategic vision for automation initiatives across operational functions, ensuring alignment with corporate goals and industry best practices. Leads the identification, design, and implementation of automation solutions (e.g., RPA, AI, workflow orchestration) to streamline operations, reduce costs, and improve service quality. Partners with business and technology stakeholders to gather requirements, define project scope, and prioritize automation opportunities. Leads vendor evaluation, negotiation of contracts, and build-vs-buy decisions for defined automation solutions. Oversees the integration of automation technologies with existing systems, ensuring seamless operation and minimal disruption. Partners with internal thought leaders to develop guardrails for AI-driven process automation, ensuring appropriate governance of the design, deployment, and life cycle management of all solutions. Establishes and enforces operational integration controls, including standardized workflows, QA checkpoints, exception-handling rules, and human-in-the-loop controls – to ensure automation-enhanced processes run safely, consistently, and in compliance with regulatory requirements. Establishes and monitors key performance indicators (KPIs) to measure the impact of automation on operational efficiency, compliance, and member satisfaction. Fosters a culture of innovation, accountability, and continuous improvement within the automation team and across the organization. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree in Business Administration, Information Technology, Healthcare Administration, or related field required
Master's Degree in a related field preferred.
10+ years of progressive leadership experience in managed care, health insurance, or healthcare operations, with a strong focus on automation and process improvement required
Strong analytical skills to interpret data, identify trends, and translate insights into actionable strategies.
Proactive approach to problem-solving and technical challenges.
In-depth knowledge of managed care operations, payer-provider relations, and regulatory requirements (e.g., HIPAA, CMS).
Familiarity with claims management, contract negotiation, and compliance tools.
Financial and operational awareness to align automation with business objectives.
Experience leading digital transformation initiatives and managing complex projects.
Demonstrated success in leading large-scale automation or digital transformation initiatives.
Excellent communication, collaboration, and stakeholder management abilities.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Bachelor's Degree in Business Administration, Information Technology, Healthcare Administration, or related field required
Master's Degree in Business Administration, Information Technology, Healthcare Administration, or related field preferred
10+ years of progressive leadership experience in managed care, health insurance, or healthcare operations, with a strong focus on automation and process improvement. required.

Responsibilities

Develops and executes the automation strategy across managed care operations.
Drives large-scale transformation initiatives, leveraging advanced technologies to optimize processes, improves quality, and enhances employee, member and provider experiences.
Collaborates with cross-functional teams, including business process owners, technology leaders, and clinical operations, to ensure automation aligns with organizational objectives and regulatory requirements.
Sets the strategic vision for automation initiatives across operational functions, ensuring alignment with corporate goals and industry best practices.
Leads the identification, design, and implementation of automation solutions (e.g., RPA, AI, workflow orchestration) to streamline operations, reduce costs, and improve service quality.
Partners with business and technology stakeholders to gather requirements, define project scope, and prioritize automation opportunities.
Leads vendor evaluation, negotiation of contracts, and build-vs-buy decisions for defined automation solutions.
Oversees the integration of automation technologies with existing systems, ensuring seamless operation and minimal disruption.
Partners with internal thought leaders to develop guardrails for AI-driven process automation, ensuring appropriate governance of the design, deployment, and life cycle management of all solutions.
Establishes and enforces operational integration controls, including standardized workflows, QA checkpoints, exception-handling rules, and human-in-the-loop controls – to ensure automation-enhanced processes run safely, consistently, and in compliance with regulatory requirements.
Establishes and monitors key performance indicators (KPIs) to measure the impact of automation on operational efficiency, compliance, and member satisfaction.
Fosters a culture of innovation, accountability, and continuous improvement within the automation team and across the organization.
Performs other duties as assigned.
Complies with all policies and standards.