VP, Payment Integrity Ops

This role is accountable for being a thought leader responsible for managing the recovery process for our clients and developing strategy for the group. This position is responsible for claims recovery production, quality, and outward facing client communication and reporting. The role will focus on understanding and developing methodologies around improving the client experience and analytics, while managing process design, planning, system function design and continuous improvement programs.

1. Drives department strategy though continued innovation; scales operations functions to support department growth and drive efficiencies; achieves department revenue and margin goals; develops and report key metrics internally and to clients.
2. Directs efforts of directors, managers, supervisors and individual contributors to ensure the completion of work in support of strategic initiatives; develops and directs procedures and methods to ensure that both client and company standards are met and maintained.
3. Measures, reports and forecasts operational performance; leads and directs the creation, maintenance and improvement of measurement systems to monitor the effectiveness of business process improvement initiatives and the impact on financial performance metrics. Completes problem analysis and problem resolution at both functional and strategic levels.
4. Determines staffing requirements; directs the interviewing, selection, and training/development process consistent with company standards. Engages and empowers employees to enhance the value of service provided to clients and customers. Scales the operational team to support company growth.
5. Establishes and implements department goals, policies and procedures in order to meet internal and external service level agreements.
6. Promotes a culture of excellence and client satisfaction by engaging and empowering employees.
7. Established and executes against new solution roadmap; provides insights and requirements to determine enabling technology requirements. Collaborates, coordinates and communicates across disciplines and departments.
8. Ensures compliance with HIPAA regulations and requirements.
9. Demonstrates company's core competencies and values held within.
10. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

This role works under minimal supervision and is afforded a wide span of influence across the department landscape. Work performed within the role will likely often be varied and complex in nature. The incumbent will work to develop and maintain strong iter/itra-departmental relationships amongst all organizational levels. This is a people management job with authority for all HR actions (hiring, firing, discipline, training, etc.).