Vice President Payment Integrity Operations About the Company Innovative provider of technology-enabled solutions for the healthcare industry
Industry
Management Consulting
Type
Privately Held
Founded
1998
Employees
1001-5000
Categories ConsultingTelecommunicationsProfessional ServicesAgency About the Role The Company is seeking a Vice President for Payment Integrity Operations. This key leadership role is pivotal in driving significant change and transformation within the operations, with a focus on optimizing the member/patient experience and supporting the mission of an affordable health system. The successful candidate will be responsible for leading a team that identifies and implements opportunities to reduce healthcare costs through improved payment integrity processes, including targeted audits, recovery efforts, and cost-containment measures. P&L management, partnering with technology for automated solutions, and ensuring the highest level of service delivery are also essential aspects of the position.
Candidates for the Vice President role should have a Bachelor's degree in healthcare administration, business, or a related field, with a Master's degree preferred. A minimum of 12-15 years of experience in healthcare, specifically in leading operations within the payment integrity vertical on health plans and vendors, is required. The role demands a leader with a deep understanding of healthcare billing, reimbursement systems, and regulatory compliance, as well as proven experience in financial management and a strong focus on driving financial savings. The ideal candidate will have excellent analytical, problem-solving, communication, and interpersonal skills, and the ability to mentor and coach a high-performing team. International travel may be necessary.
Hiring Manager Title
SVP - Global PI Operations
Travel Percent
Less than 10%
Functions FinanceOperations