Program Lead, Payor Connections/Interoperability in United States at Jobgether
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Job Description
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Program Lead, Payor Connections/Interoperability based in the United States.
This role sits at the center of critical healthcare data interoperability initiatives, driving how provider systems and payor networks exchange accurate, timely, and compliant information. You will lead cross-functional programs that improve data connectivity and strengthen Risk Adjustment operations through scalable interoperability solutions. Operating with a high degree of autonomy, you will manage end-to-end initiatives—from strategy and partner engagement to execution, testing, and performance monitoring. You will collaborate with internal stakeholders and external provider organizations to ensure seamless healthcare data acquisition and integration. This position requires someone comfortable navigating ambiguity, building structure in evolving environments, and owning complex operational programs. Your work will directly influence data quality, regulatory compliance, and the effectiveness of healthcare insights across the organization. It is an opportunity to shape foundational interoperability capabilities within a fast-moving, technology-driven healthcare environment.
- Lead end-to-end interoperability programs supporting Risk Adjustment and payor-provider data exchange initiatives
- Develop and manage relationships with provider organizations, vendor partners, and external stakeholders to ensure effective data connectivity
- Build and maintain detailed project plans, ensuring timely execution and alignment across multiple workstreams
- Oversee testing, validation, and monitoring of healthcare data connections to ensure accuracy, compliance, and functionality
- Partner cross-functionally to define operational strategies, improve workflows, and drive measurable program impact
- Identify, troubleshoot, and resolve data quality, integration, and system issues across interoperability initiatives
- Develop, maintain, and enhance operational dashboards to track performance and support decision-making
- Serve as a subject matter expert on TEFCA and related interoperability frameworks and regulations
- 3+ years of experience in healthcare operations, health insurance, or provider-facing healthcare roles
- 2+ years of experience delivering interoperability programs or large-scale data integration initiatives
- Strong understanding of healthcare data exchange, payor-provider systems, and interoperability standards, including TEFCA
- Proven ability to manage complex projects end-to-end in ambiguous, fast-changing environments
- Strong analytical and problem-solving skills with the ability to interpret data and identify actionable insights
- Experience working with cross-functional stakeholders including technical, operational, and clinical teams
- Excellent communication skills and ability to build and maintain external partner relationships
- Bonus: experience in Risk Adjustment operations
- Bonus: familiarity with SQL or BigQuery for data analysis and reporting
- Competitive base salary range: $91,659 – $120,303 per year
- Annual performance-based bonus eligibility
- Unlimited paid time off program
- Comprehensive medical, dental, and vision insurance coverage
- Paid parental leave and paid sick time
- 401(k) retirement savings plan
- Life and disability insurance coverage
- Wellness time and reimbursement programs
- Flexible remote work arrangement (U.S.-based eligibility requirements apply)
- Opportunity to work on high-impact healthcare interoperability initiatives.