Associate Vice President of Claims

Job Summary

Leading the enterprise claim payment accuracy strategy, the full-time Associate Vice President of Claims will manage cross-functional initiatives to identify and remediate issues causing incorrect claims payments, all while working remotely.

Key responsibilities

• Define and implement the claim payment accuracy strategy and governance model
• Direct root-cause analytics to identify systemic payment defects and translate findings into actionable remediation plans
• Chair governance forums to review payment accuracy portfolios and ensure effective cross-functional collaboration

Required qualifications

• 10+ years of experience in health plan claims, payment integrity, or related fields, with at least 5 years in leadership roles
• Strong understanding of end-to-end claim payment processes and upstream factors affecting payment accuracy
• Proven track record of conducting root-cause analysis and driving corrective actions across multiple functions
• Experience in establishing governance and executive reporting for complex remediation initiatives
• Bachelor's degree in business, healthcare administration, analytics, finance, or a related field