Assistant Vice President of Quality – Payment Integrity, Healthcare

EXL•United States,

2d•$130,000 - $145,000•Remote

About The Position

Shape the future of Payment Integrity and Healthcare Quality Audits. We’re hiring a dynamic Assistant Vice President (AVP) of Quality to lead and advance quality operations across clinical, coding, third party liability, and operational audits within Payment Integrity. Reporting to the Senior Assistant Vice President of Global Quality, you’ll provide strategic leadership to Quality Managers and their teams—ensuring every deliverable meets or exceeds internal KPIs, SLAs, and client expectations. This is a mission-critical role driving quality excellence, proactive risk mitigation, scalable quality operations, and continuous process improvement to support rapid growth. You’ll partner closely with Operations, Training, Technology, and global quality stakeholders to align processes, scale capabilities, and deepen knowledge across the organization. If you’re a strategic, results-driven leader passionate about quality, innovation, and measurable impact, we want to hear from you.

Requirements

Bachelor’s degree in healthcare, business, or related field (advanced degree preferred).
7-10+ years of experience in healthcare quality operations, clinical/coding auditing, or payment integrity programs.
7-10+ years proven leadership experience managing quality teams in complex, fast-paced environments.
Expertise in quality methodologies and process improvement (Lean, Six Sigma, etc.).
Experience with audit tools, dashboards, reporting systems, and advanced Excel.
Strong analytical, strategic thinking, and problem-solving abilities; able to turn insights into action.
Exceptional verbal, written, and presentation communication skills.
Ability to drive operational excellence while maintaining quality standards.
Digital mindset with a knack for automation and scalable solutions.
Collaborative leadership style—able to align multiple teams and global partners.
Strong time management, prioritization, and stakeholder management skills.
Demonstrated ability to coach, develop, and inspire high-performing professionals.
Commitment to continuous learning and a culture of quality excellence.

Nice To Haves

advanced degree preferred

Responsibilities

Lead end-to-end healthcare quality operations for clinical, coding, TPL, and operational audits, ensuring accuracy, compliance, and operational excellence.
Lead a team of Quality Managers and their teams, driving consistency in audit methodology, scoring standards, and governance.
Lead Quality strategy—short and long term—rooted in data-driven insights, risk identification, and process excellence.
Lead Cross-functional collaboration for global alignment to unify standards, scale solutions, and share best practices.
Drive overall operational quality performance, to achieve accuracy standards, KPIs, SLAs, and exceed client expectations.
Develop and mentor the quality leaders and team, fostering accountability, continuous improvement, and quality excellence.
Develop and oversee quality audit methodologies, scoring frameworks, and governance protocols, ensuring consistent and high-quality execution across all audit programs.
Proactively identify process risks and implement initiatives to enhance audit quality, leveraging audit data and trend analysis to improve quality outcomes.
Lead quality readiness for new programs, clients, and rapid growth, ensuring scalable processes.
Drive continuous improvement initiatives using root cause analysis, data analytics and process evaluation to enhance quality, efficiency, and scalability.
Leverage trends and metrics to identify and drive automation and process improvements that optimize processes and outcomes.
Lead initiatives to automate processes and enhance efficiencies, driving improvements in audit quality, scalability, and organizational outcomes; partner with Technology to implement digital solutions.
Design and oversee scalable repeatable processes, ensuring consistent execution and sustainable operational quality.
Lead Quality Managers and their teams, providing guidance, mentorship, and coaching to consistently achieve goals, through high-quality audit performance.
Strengthen depth of knowledge across team, implementing calibration, coaching, and upskilling initiatives to align quality audit teams.
Drive a high-performing, accountable, quality-focused culture, modeling standards and reinforcing behaviors that elevate team and operations performance.
Cultivate a results-driven quality team, delivering insights, coaching, and guidance to operational areas, while recommending process improvements to drive consistent audit quality outcomes.
Partner with global quality leaders to align processes, metrics, and audit standards.
Collaborate with Operations, Training, and Technology to drive improvements.
Share best practices and insights across regions to ensure a unified approach.
Lead and support change management initiatives and strategic quality projects.
Oversee all operational quality performance, tracking KPI’s and performance metrics and leading actions plan to address gaps and drive improvement.
Deliver insight-driven reporting to senior leadership and stakeholders, highlighting trends, performance gaps, and strategic opportunities to enhance quality outcomes.
Drive implementation of improvement plans based on audit insights, enhancing operational quality, consistency, and performance across both the quality team and all audit programs.
Establish and maintain SOPs, governance frameworks, and documentation ensuring they are current, effective and consistently applied.
Lead Quality Managers And their teams, providing guidance, mentorship, and coaching to ensure consistence performance and achievement of goals.
Oversee operational quality performance, ensuring audit programs consistently meet or exceed KPI's, SLAs, and quality standards.
Manage capacity planning, productivity, and workload distribution within the quality team.
Drive quality performance, risk mitigation, and continuous improvement initiatives, translating audit insights into measurable audit outcomes.
Ensure alignment of quality standards across programs and global regions, promoting consistency, best practices, and operational quality excellence.