Executive AVP, Claim Payment Accuracy & Transformation

Alignment Healthcare USA, LLC; Orange (CA); On-site; USD 198,000 - 297,000; Full time

Job summary

Alignment Health is seeking an Associate Vice President, Claim Payment Accuracy to lead the enterprise strategy, governance, and multi-year roadmap for improving claim payment accuracy. You will drive root-cause analytics, partner with data and technology teams, and coordinate cross-functional remediation across departments to reduce leakage and improve eligibility and payout correctness.

The role requires senior-level communication, transformation leadership, and an ability to influence

Qualifications

• Bachelor's degree in business, healthcare administration, analytics, finance, information systems, engineering, or related field or equivalent experience.
• Master's degree preferred.
• Extensive experience in health plan claims, payment integrity, or enterprise transformation.
• Strong governance, portfolio management, and executive reporting experience.
• Ability to influence senior leaders and drive cross-functional initiatives.

Responsibilities

• Define and lead the enterprise claim payment accuracy strategy, operating model, governance, and multi-year roadmap.
• Lead root-cause analytics to identify systemic payment defects and drive upstream fixes.
• Coordinate remediation across Claim Operations, Configuration, Product, Technology, and Finance.
• Validate fixes and quantify prevented value; monitor recurrence and sustained results.
• Provide executive-level guidance and cross-functional governance for payment accuracy.

Skills

Analytical leadership

Executive communication

Transformation leadership

Cross-functional collaboration

Financial discipline

Education

Bachelor's degree

Master's degree (preferred)

Tools

SQL

Data visualization

Facets (or similar core claims platform)

Job description

Alignment Health is seeking an Associate Vice President, Claim Payment Accuracy to lead the enterprise strategy, governance, and multi-year roadmap for improving claim payment accuracy. You will drive root-cause analytics, partner with data and technology teams, and coordinate cross-functional remediation across departments to reduce leakage and improve eligibility and payout correctness.

The role requires senior-level communication, transformation leadership, and an ability to influence