VP, Payment Integrity & Health Cost Optimization

Alignment Healthcare USA, LLC; Orange (CA); On-site; USD 228,000 - 342,000; Full time

Job summary

Alignment Health seeks a strategic and data-driven VP, Payment Integrity to shape and lead the enterprise program. You will drive the multi-year strategy, governance, and partnerships, delivering measurable savings while maintaining provider relationships and regulatory compliance.

You will partner with Finance, Claims Operations, and Technology to align investments, oversee a complex vendor portfolio, and advance prevention-based payment integrity across prepay and postpay programs.

Qualifications

• Bachelor's degree in business, healthcare administration, finance or related field.
• Master's degree preferred.
• Experience leading Payment Integrity strategy and multi-vendor programs.

Responsibilities

• Develop and lead multi-year Payment Integrity strategy and roadmap.
• Set executive performance framework and governance for savings and compliance.
• Oversee vendor portfolio, sourcing, and contractual commitments.
• Provide executive reporting on financial performance and program outcomes.
• Lead transformation, insourcing, and capability modernization initiatives.

Skills

Strategic leadership

Executive decision-making

Technical & analytics

Financial acumen

Vendor leadership

Enterprise influence

Organizational leadership

Transformation leadership

Education

Bachelor's degree in business/healthcare admin/finance

Master's degree (preferred)

Tools

Facets or core claims platform

Job description

Alignment Health seeks a strategic and data-driven VP, Payment Integrity to shape and lead the enterprise program. You will drive the multi-year strategy, governance, and partnerships, delivering measurable savings while maintaining provider relationships and regulatory compliance.

You will partner with Finance, Claims Operations, and Technology to align investments, oversee a complex vendor portfolio, and advance prevention-based payment integrity across prepay and postpay programs.