Associate Vice President - Payment Integrity

Sagility

13d • Remote

About The Position

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries. The incumbent will be accountable directly and indirectly through a matrix team. He/She will be partnering with key value streams and business units within Sagility Payment Integrity Organization. This role is essential for supporting the mission of affordable health system for all and drive financial savings.

Requirements

• Bachelor’s degree in healthcare administration, Business, or a related field. Master's degree preferred.
• Minimum of 9-12 years of experience in healthcare, with focus on leading Operations within the Payment Integrity Vertical on Health Plan & Vendor.
• Experience in directly interfacing with and managing clients with integrity and transparency.
• Financial Acumen and Attention to Detail.
• Proven leadership experience with the ability to motivate and develop a high-performing team.
• In-depth knowledge of healthcare regulations and compliance requirements.
• Excellent analytical and problem-solving skills.
• Effective communication and interpersonal skills.
• Ability and willingness to travel internationally.

Responsibilities

• Effectively manage a work from home and potentially offshore teams.
• Oversee and lead a team to Identify opportunities to reduce healthcare costs for the companies’ clients through improved payment integrity processes, such as targeted audits, recovery efforts, and cost containment measures to meet and exceed monthly and annual company and client goals.
• P&L Management for assigned teams.
• Partner with Technology towards building and improving automated solutions and the audit workstation utilized by staff to manage the overpayment recovery process.
• Utilize systems tools to manage performance and its impact on the financial goal while Delivering Highest Level of Service Delivery requirements.
• Mentoring & Coaching Operational & Leadership values.
• Creating strong client partnerships and help grow the accounts across Sagility service offerings.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees