Vice President of Medicare Advantage

Job Summary

A company is looking for a Vice President, Payment Integrity.

Key Responsibilities

• Own the enterprise revenue integrity strategy across all MAPD and DSNP members
• Lead a high-performing team across analytics and operations while maintaining KPIs and audit programs
• Quantify revenue opportunities and partner with actuarial and finance to forecast financial impacts

Required Qualifications

• 10+ years of experience in Medicare Advantage with a focus on payment integrity or revenue integrity operations
• Deep understanding of CMS payment processes and error amendment capabilities
• Proven ability to deliver measurable financial results and operational improvements
• Skilled in managing teams and influencing senior executives in complex environments
• Strong analytical and process design capabilities