VP, Payment Integrity Strategy & Partnerships

Alignment Health; Sacramento (CA); Remote; USD 228,000 - 342,000; Full time

Job summary

Alignment Health is seeking a Senior VP of Payment Integrity to lead enterprise strategy, governance, and performance across prepay and postpay programs. The role emphasizes cost reduction, provider impact, and scalable operations within a payer environment.

The leader will drive a comprehensive analytics framework, partner with Finance and Medical Economics, and ensure compliance with CMS and regulatory requirements while delivering measurable savings and improved payment accuracy.

Qualifications

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

Responsibilities

• Develop, recommend, and lead the multi-year Payment Integrity strategy and capability roadmap with priorities, investments, and performance expectations.
• Own delivery of the financial plan and validated savings, setting targets in partnership with Finance and Medical Economics.
• Provide executive oversight of prepay and postpay programs, including benefits, coding, reimbursement, and complex-claim capabilities.
• Define data, measurement, and analytics strategy; translate insights into actionable improvements in claims configuration and reimbursement policies.
• Lead governance for the Payment Integrity portfolio, ensuring accountability for savings, quality, and provider impact.
• Build and scale a high-performing Payment Integrity organization with clear decision rights and succession plans.

Skills

Strategic leadership

Executive decision-making

Technical analytics

Financial acumen

Vendor leadership

Enterprise influence

Organizational leadership

Transformation leadership

Mission focus

Education

Bachelor's degree in business/healthcare/finance

Master's degree (preferred)

Job description

Alignment Health is seeking a Senior VP of Payment Integrity to lead enterprise strategy, governance, and performance across prepay and postpay programs. The role emphasizes cost reduction, provider impact, and scalable operations within a payer environment.

The leader will drive a comprehensive analytics framework, partner with Finance and Medical Economics, and ensure compliance with CMS and regulatory requirements while delivering measurable savings and improved payment accuracy.