VP, Payment Integrity

📋 Description

• Lead payment integrity strategy and execution, including pre/post-pay reviews and FWA prevention
• Design solutions to reduce leakage across the claims lifecycle via internal and vendor programs
• Prioritize opportunities to deliver additional savings in the program ecosystem
• Build and manage multi-vendor portfolio with strong SLAs and optimized contingency fees
• Provide executive leadership over all payment integrity operations
• Lead strategy to insource payment integrity where appropriate

🎯 Requirements

• 15+ years leadership in healthcare claims or payment integrity with executive responsibility
• Deep expertise in medical claims operations, payment integrity, claims configuration, and regulatory compliance
• Proven experience scaling operations in high-growth or complex environments
• Strong understanding of healthcare regulations, audits, and best practices
• Ability to lead large, distributed teams and manage complex vendor relationships
• Strategic thinker with strong analytical, financial, and operational acumen

🎁 Benefits

• Health and wellness benefits
• Alternative medicine coverage
• Flexible PTO
• Up to 16 weeks paid parental leave
• 401k program
• Transportation perks