Remote AVP, Claim Payment Accuracy & Transformation

Alignment Health; Orange (CA); Remote; 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 for reducing payment errors and leakage. This executive role partners across Payment Integrity, Claim Operations, Configuration, Technology, Finance, Compliance, Network, and other claim-adjacent functions.

You will own governance, define a multiyear roadmap, direct root-cause analytics, and drive upstream remediation with cross-functional teams to sustain improvements.

Qualifications

• 10+ years of health plan claims, payment integrity, or enterprise transformation experience.
• 5+ years leading cross-functional programs or teams.
• Strong governance, analytics, and executive communication skills.

Responsibilities

• Own the enterprise claim payment accuracy agenda and multiyear roadmap.
• Lead root-cause analytics translating findings into upstream fixes.
• Drive remediation from discovery to sustainable implementation across functions.
• Integrate FWA patterns into preventive controls and policy improvements.
• Chair governance forums and communicate exposure and progress to leadership.
• Build the capability and team with analytics, remediation, and transformation skills.

Skills

Systems thinker

Analytical leader

Operational excellence

Transformation leadership

Enterprise influence

Financial discipline

Pragmatic judgment

Clear communication

Education

Bachelor's degree

Master's degree

Tools

Facets

SQL

Data Visualization tools

Job description

Alignment Health is seeking an Associate Vice President, Claim Payment Accuracy to lead the enterprise strategy for reducing payment errors and leakage. This executive role partners across Payment Integrity, Claim Operations, Configuration, Technology, Finance, Compliance, Network, and other claim-adjacent functions.

You will own governance, define a multiyear roadmap, direct root-cause analytics, and drive upstream remediation with cross-functional teams to sustain improvements.