Vice President Payment Integrity Operations

Job Code : REQ-005113

Work@Home USA Fully Remote

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Job Description

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.

We are currently hiring a talented Vice President ? Payment Integrity Operations. This is a key leadership position, within a high value, fast paced and growing function and will lead significant change and transformation within the operations reporting to the SVP ? Global PI Operations.

The successful candidate is accountable directly and indirectly through a matrix team. You 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. Working within the Business Performance Unit, you?ll have the opportunity to work collaboratively within a high-performance team, responsible for driving successful Transformation Program.

This position requires a deep understanding of healthcare billing, reimbursement systems, regulatory compliance, and effective leadership skills.

Job title:

Vice President Payment Integrity Operations

Job Description:

Key Requirements:

Lead Sagility Payment Integrity Operations as an Operations Leader with a combination of managing onsite and offshore teams.
Oversee and lead a team to Identify opportunities to reduce healthcare costs through improved payment integrity processes, such as targeted audits, recovery efforts, and cost containment measures.
P&L Management (Revenue management, Cost Optimization, Improvements).
Partner with Technology towards building and improving automated solutions.
Track program 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 periodically.

Education, Experience, and Skills:

Bachelor?s degree in healthcare administration, Business, or a related field. Master's degree preferred.
Minimum of 12-15 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.

Sagility Offers Competitive Benefits Including: