Vice President, Payment Integrity Remote (anywhere in United States)

The Company is seeking a Vice President of Payment Integrity to lead the strategy, market positioning, financial performance, and operational execution of its payment integrity capabilities. The role will set the long-term vision and commercialization roadmap, guide investment and innovation, and align product, technology, sales, operations, finance, and client teams. Responsibilities include driving client adoption and measurable outcomes, developing strategic partnerships, establishing governance and performance metrics, and building an organization equipped for growth. The executive will also represent the function with clients and industry stakeholders and use market and client insights to inform ongoing development. Candidates should have a bachelor’s degree and 10–15 or more years of experience in healthcare, payment integrity, claims operations, or a related field, including at least seven years in senior leadership; an advanced degree is preferred. Strong expertise in payment integrity methods, claims editing, payment policy, cost containment, payer operations, reimbursement, and healthcare analytics is required. Applicants should have experience leading enterprise-scale transformation, owning business and operational outcomes, and influencing executive stakeholders in complex organizations. Excellent communication and presentation skills, external industry leadership experience, and the ability to align cross-functional teams are also essential.

Hiring Company

HealthEdge