Senior AVP, Encounter Data & Revenue Integrity

Alignment Healthcare USA, LLC in; Orange (CA); On-site; USD 178,000 - 297,000; Full time

Job summary

Alignment Health is hiring an Associate Vice President, Encounters to lead the encounter data function, ensuring complete and accurate CMS Part C and Part D submissions. You will coordinate with Claims Operations, Configuration, Technology, Compliance, Finance, Network Management, and delegated oversight to improve data quality, controls, and performance.

The AVP will own encounter data governance, submission performance, and remediation, partnering with Risk Adjustment to optimize revenue while

Qualifications

• Strong leadership to design and launch an encounters function.
• Excellent reconciliation and data-quality discipline.
• Ability to translate complex data problems for executives.

Responsibilities

• Build the Encounters Function and governance.
• Lead cross-functional alignment with Claims Operations, Technology, Compliance, Finance.
• Oversee Part C/EDPS submissions and PDE for Part D with validation.
• Establish data quality framework, error taxonomy, and remediation.
• Drive ongoing process improvement, risk reduction, and revenue optimization.
• Partner with Risk Adjustment for revenue opportunity identification.

Skills

Builder

Technical mindset

Operational rigor

Financial acumen

Influence

Root-cause orientation

Education

Bachelor's degree in business/healthcare/finance

Master's degree (preferred)

Tools

Facets

Job description

Alignment Health is hiring an Associate Vice President, Encounters to lead the encounter data function, ensuring complete and accurate CMS Part C and Part D submissions. You will coordinate with Claims Operations, Configuration, Technology, Compliance, Finance, Network Management, and delegated oversight to improve data quality, controls, and performance.

The AVP will own encounter data governance, submission performance, and remediation, partnering with Risk Adjustment to optimize revenue while