VP, Payment Integrity & Savings Strategy

E2E Alignment Healthcare USA, LLC; California; On-site; USD 228,000 - 342,000; Full time

Job summary

Alignment Health is seeking a senior leader to architect and drive the Payment Integrity strategy, overseeing a multi-year roadmap, cross-functional governance, and executive reporting. You will lead end-to-end initiatives from clinicians and coding to reimbursement, ensuring compliant, cost-effective outcomes for the payer and providers.

The role requires deep payer experience, proven leadership of large, multi-vendor programs, and a track record of validated savings.

Qualifications

• 12+ years of progressive experience in healthcare Payment Integrity, claims operations, or a closely related function.
• Health plan (payer) experience required, including direct leadership of Payment Integrity programs.
• Experience leading a multi-vendor Payment Integrity portfolio with vendor selection, contract and pricing negotiation, and governance.

Responsibilities

• Develop and lead the multi-year Payment Integrity strategy and capability roadmap with priorities, investments, and performance expectations.
• Own delivery of the approved Payment Integrity financial plan and validated savings commitments; set annual targets and corrective actions.
• Set strategic direction to evolve Payment Integrity from retrospective recovery toward prospective prevention and improved first-pass payment accuracy.
• Establish and govern the enterprise Payment Integrity operating model, policy standards, and control framework.
• Define executive reporting of Payment Integrity savings, financial return, and program performance to drive investment decisions.
• Lead governance for the Payment Integrity vendor portfolio and ensure alignment with enterprise objectives.
• Provide oversight of prepayment and postpayment capabilities, including awareness of compliance, coding, and recovery strategies.

Skills

Strategic leadership

Executive collaboration

Education

Bachelor's degree in business, healthcare administration, finance

Master's degree (preferred)

Tools

Facets

Job description

Alignment Health is seeking a senior leader to architect and drive the Payment Integrity strategy, overseeing a multi-year roadmap, cross-functional governance, and executive reporting. You will lead end-to-end initiatives from clinicians and coding to reimbursement, ensuring compliant, cost-effective outcomes for the payer and providers.

The role requires deep payer experience, proven leadership of large, multi-vendor programs, and a track record of validated savings.