Remote VP, Payment Integrity & Cost Strategy

Alignment Health

Orange (CA)

Hybrid

USD 228,000 - 342,000

Full time

3 days ago

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Job summary

Alignment Health is seeking a Vice President of Payment Integrity to lead our enterprise program, drive a strategic shift toward proactive prevention, and optimize the payer-side ecosystem. You will shape the roadmap, align cross-functional teams, and ensure measurable financial outcomes while safeguarding provider relationships and member experience.

The role requires deep expertise in healthcare payment integrity, analytics, and executive leadership to influence across Finance, Network,

Qualifications

12+ years of progressive experience in healthcare Payment Integrity, claims operations, or a closely related function with leadership accountability.
Experience leading a multi-vendor Payment Integrity portfolio and executive-level governance.
Deep knowledge of prepay and postpay disciplines, coding edits, DRG validation, COB, subrogation, and related reimbursement methods.

Responsibilities

Develop and lead the multi-year Payment Integrity strategy and capability roadmap.
Own delivery of the financial plan and validated savings commitments; set targets with Finance and Medical Economics.
Establish the operating model, governance, and executive reporting for Payment Integrity; drive provider impact and regulatory alignment.
Oversee vendor portfolio strategy, sourcing, negotiation, and performance governance.
Provide executive oversight of postpayment audit, recovery, COB, and subrogation capabilities; ensure measurable outcomes.