AVP, Claim Payment Accuracy & Transformation

E2E Alignment Healthcare USA, LLC; California; On-site; USD 198,000 - 297,000; Full time

Job summary

Alignment Health seeks an Executive leader to define and drive the enterprise claim payment accuracy strategy, governance, and multiyear roadmap. This role partners across Payment Integrity, Claim Audit, Ops, Finance, and Technology to reduce leakage and strengthen upstream controls.

The AVP will lead analytics-enabled remediation, establish clear accountability, and influence senior leaders without direct authority, ensuring durable, measurable outcomes across the organization.

Qualifications

• 10+ years in health plan claims, payment integrity, or related field.
• Experience leading cross-functional remediation or transformation initiatives.
• Proven ability to influence senior leaders and drive accountability.

Responsibilities

• Define and lead the enterprise claim payment accuracy strategy, operating model, governance, and multiyear roadmap.
• Create a transparent portfolio of payment issues across signals and remediation areas.
• Direct analytics-led capabilities to identify systemic payment defects and necessary upstream fixes.
• Translate findings into remediation plans with milestones and ownership.
• Lead governance forums and communicate exposure and progress to executive leadership.

Skills

Leadership

Analytics

Executive communication

Cross-functional influence

Education

Bachelor's degree in business, healthcare administration, analytics, finance, information systems, engineering, or related field

Master's degree (preferred)

Tools

Facets

Job description

Alignment Health seeks an Executive leader to define and drive the enterprise claim payment accuracy strategy, governance, and multiyear roadmap. This role partners across Payment Integrity, Claim Audit, Ops, Finance, and Technology to reduce leakage and strengthen upstream controls.

The AVP will lead analytics-enabled remediation, establish clear accountability, and influence senior leaders without direct authority, ensuring durable, measurable outcomes across the organization.