VP, Payment Integrity — Lead First-Pass Accuracy

Alignment Health; United States; Remote; USD 250,000 - 450,000; Full time

Job summary

Alignment Health is seeking a Vice President of Payment Integrity to lead the enterprise strategy, governance, and execution of programs across prepay and postpay to improve payment accuracy, cost performance, and provider relationships.

The role requires payer-side expertise, a data-driven mindset, and the ability to influence leaders across Finance, Network, Technology, and Compliance. Strategic vendor partnerships and innovative use of technology are expected.

Qualifications

• Payer-side Payment Integrity expertise.
• Technical and data-driven mindset.
• Strong financial and strategic acumen.

Responsibilities

• Develop, recommend, and lead execution of the multi-year Payment Integrity strategy and capability roadmap.
• Own delivery of the approved Payment Integrity financial plan and validated savings commitments; set targets and investments.
• Shift from retrospective recovery toward prospective prevention and first-pass payment accuracy while protecting provider relationships and member experience.
• Establish and govern the enterprise Payment Integrity operating model, policies, and control framework.
• Establish the executive performance framework for Payment Integrity with transparent measurement of savings, return, and performance.

Job description

Alignment Health is seeking a Vice President of Payment Integrity to lead the enterprise strategy, governance, and execution of programs across prepay and postpay to improve payment accuracy, cost performance, and provider relationships.

The role requires payer-side expertise, a data-driven mindset, and the ability to influence leaders across Finance, Network, Technology, and Compliance. Strategic vendor partnerships and innovative use of technology are expected.