VP, Payment Integrity & Strategic Partnerships

Alignment Health; California; Remote; USD 228,000 - 342,000; Full time

Job summary

Alignment Health seeks a Senior Vice President, Claims & Payment Integrity to lead the enterprise PI strategy, governance, and partnerships. This role directs cross-functional teams, drives first-pass payment accuracy, and delivers validated savings while maintaining provider relationships and regulatory compliance.

Responsibilities include shaping the PI roadmap, optimizing vendor portfolios, and coordinating with Finance, Network, and Compliance to align with enterprise objectives.

Qualifications

• Experience leading Payment Integrity in healthcare payers or related organizations.
• Ability to set strategy and govern multi-vendor portfolios.
• Strong understanding of reimbursement methodologies and coding standards.

Responsibilities

• Lead the multi-year Payment Integrity strategy and capability roadmap.
• Own the financial plan, target setting, and savings commitments with Finance.
• Shift focus from retrospective recoveries to preventive, first-pass accuracy.
• Establish governance, policies, and control framework for Payment Integrity.
• Provide executive reporting on savings, performance, and risk.

Skills

Strategic leadership

Executive presence

Financial acumen

Strategic vendor leadership

Enterprise influence

Organizational leadership

Transformation leadership

Mission focus

Analytical thinking

Leadership of cross-functional teams

Education

Bachelor's degree in business, healthcare administration, finance, or related field

Tools

Facets core claims

AI/ML in Payment Integrity

Job description

Alignment Health seeks a Senior Vice President, Claims & Payment Integrity to lead the enterprise PI strategy, governance, and partnerships. This role directs cross-functional teams, drives first-pass payment accuracy, and delivers validated savings while maintaining provider relationships and regulatory compliance.

Responsibilities include shaping the PI roadmap, optimizing vendor portfolios, and coordinating with Finance, Network, and Compliance to align with enterprise objectives.