VP of Payment Integrity

Job Summary

Leading the payment integrity function, the full-time remote VP of Payment Integrity will drive strategy and execution for claims accuracy, manage vendor relationships, and build a high-performing team to enhance payment integrity operations.

Key responsibilities

• Lead payment integrity strategy, including fraud, waste, and abuse prevention efforts
• Design solutions to address claims lifecycle leakage and develop internal capabilities
• Build and manage a high-performing multi-vendor portfolio while ensuring operational excellence

Required qualifications

• 15+ years of leadership experience in healthcare claims or payment integrity operations
• Deep expertise in medical claims operations and regulatory compliance
• Proven ability to scale operational organizations in high-growth environments
• Strong understanding of healthcare regulations and industry best practices
• Demonstrated experience leading large teams and managing complex vendor relationships