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.)
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.
JOB RESPONSIBILITIES
- 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
- Work with internal EXL PI Compliance Team to ensure all compliance requirements are adhered to and complete all required compliance related tasks
- 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
- 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
- Assist with creating and maintaining Statement of Policy (SOP) to ensure compliance with client Statement of Work as well as with compliance of internal policies and procedures, external regulations, and information security standards
JOB QUALIFICATIONS
- 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.
