Job Description

💰 Salary Range: $125,000 – $160,000 (based on experience, skills, and qualifications)
📍 Location: 100% Remote (U.S.-based)

✈️ 10 - 25% annual travel (for team meetings and limited client onsite engagements.)

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

The posted range is the hiring range for this role — a subset of the broader range available to employees over time — and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.

Are you an experienced Payment Integrity leader looking for the next step in your career path? Is it time for a change? Explore this opportunity with a new, exciting, and dynamic growth-oriented team.

In this role you will collaborate with a diverse group of Payment Integrity Audit Program leaders, and our operational team members to manage the day-to-day operations to ensure timely completion of each step of the complex audit process from selection to recovery. The successful candidate will be passionate, quality focused and have a diverse background in Payment Integrity Complex Audit & Recovery programs.

In this role, the Assistant Vice President will work closely with a diverse group of Payment Integrity Audit Program leaders, key client stakeholders, and cross-functional teams to implement and enhance client and business requirements. You will ensure that systems and processes consistently meet or exceed compliance standards and client expectations.

The successful candidate will be passionate, quality focused and have a diverse background in payment integrity audits, advanced project and inventory management, experience reviewing provider contractual terms to assist with the development of selection criteria and audit guidelines.

As a key member of our team, you will collaborate across departments to proactively identify and resolve areas of potential risk or concern that may impact optimal recovery outcomes. You will thrive in an environment that values innovation, teamwork, and excellence, and you’ll be empowered to contribute your expertise in a culture built on collaboration, inclusiveness, and ongoing support.

• Collaborate across all current and future client PI Audit programs to define and document client business requirements
• Create and maintain client Provider Communication templates; work on client requested updates as required
• Inventory and SLA monitoring, work with stakeholders to resolve any inventory aging
• Maintain the Pod/DIGI-E Roadmap
• Participate in Pod/DIGI-E Roadmap meetings and document Pod Roadmap updates
• Document Visio workflows for discussion and incorporate into Policies and Procedures as needed
• Reporting- Internal and client reporting work with reporting team to provide report logic to ensure accurate reporting
• Client MBR/SABR Reporting- work with reporting team to provide report logic to ensure accurate reporting
• Support work environment to facilitate employee satisfaction, people development, continuous process improvement, quality, productivity, and client satisfaction.
• Assist with strategic implementation & management of Payment Integrity Complex Audit & Recovery programs across multiple clients.
• Monitor Key Performance Indicators to ensure audit inventory is not aging and at risk for cancellation
• Identify and assist with implementing process enhancements that optimize recovery opportunities
• Inventory Management across all audit programs to ensure audits are on track, work with team members to problem solve aging inventory or other operational issues
• Assist with creating and maintaining Statement of Work to ensure KPIs/SLAs and client goals are established and met
• Assist with hiring, on-boarding, and training as appropriate for new employees
• Capable of building and maintaining strong interdepartmental working relationships
• Support operational projects and activities to drive process improvement which may include participation in technical/business discovery conversations, completion of root cause analysis to identify and solve for operational challenges/barriers to program success.

• 10 plus years’ experience in Payment Integrity with Complex & Automated Audit & Recovery programs preferred
• Bachelor’s degree preferred
• Six Sigma Certification Green Belt or Higher
• PMP- Credential with Project Management experience strong project management, and analytical skills, with attention to detail
• Strong leadership skills, with the ability to develop work plans, action plans, and standard operating procedures
• Excellent oral and written communication skills
• Strong relationship building skills
• Data-driven problem solving, cross-functional leadership, knowledge of financial fundamentals
• Advanced skills in Word, Excel, and PowerPoint

What We Offer:

✨ A fast-paced, innovative environment with a team of industry-leading experts
✨ Hands-on experience with top-tier clients in the healthcare industry.
✨ Mentorship and career development programs to help you grow professionally.
✨ A strong culture of collaboration, support, and inclusivity
✨ Competitive benefits package, including healthcare, vision, dental, and 401(k) options

Ready to Take Your Career to the Next Level?

If you're looking for a rewarding and challenging opportunity where your expertise will be valued, your growth will be supported, and your contributions will make a difference— apply today and become part of the EXL team!