Gravie logo
Gravie

We partner with brokers across the nation to improve the way people purchase and access healthcare.

VP, Payment Integrity

Vice PresidentVice PresidentFull TimeRemoteLeadTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

5 days ago

Salary

$207K - $304K / year

Seniority

Lead

Postgraduate Degree15 yrs expEnglish

Job Description

VP, Payment Integrity

Gravie

• Lead payment integrity strategy and execution, including pre- and post-payment reviews, fraud, waste, and abuse (FWA) prevention, and recovery efforts • Design and lead solutions to address leakage throughout the claims lifecycle, including developing internal capabilities and implementing external vendor programs • Assess the current payment integrity program ecosystem and prioritize opportunities to deliver additional savings • Build and manage a high-performing multi-vendor portfolio, enforcing rigorous SLAs and optimizing contingency fee structures to maximize financial yields while actively mitigating provider abrasion • Provide executive leadership over all payment integrity operations, ensuring high performance of all internal and external PI programs • Lead strategy and execution to insource payment integrity opportunities as appropriate • Establish and monitor savings and operational KPIs • Develop, scale and optimize payment integrity operations to support business growth, new products, and regulatory requirements • Partner with Finance and Med Econ to ensure detailed savings tracking of payment integrity initiatives • Build, mentor, and lead a high-performing leadership team with a strong culture of accountability, collaboration, and continuous improvement • Build strong leadership and career pathways within the organization to support retention and succession planning

Job Requirements

  • 15+ years of progressive leadership experience in healthcare claims or payment integrity operations
  • Deep expertise in medical claims operations, payment integrity, claims configuration, and regulatory compliance
  • Proven experience scaling operational organizations in high-growth or complex environments
  • Strong understanding of healthcare regulations, audit requirements, and industry best practices
  • Demonstrated ability to lead large, distributed teams and manage complex vendor relationships
  • Strategic thinker with strong analytical, financial, and operational acumen

Benefits

  • Health insurance
  • 401k program
  • Flexible PTO
  • Up to 16 weeks paid parental leave
  • Paid holidays
  • Cell phone reimbursement
  • Transportation perks
  • Education reimbursement
  • 1 week of paid paw-ternity leave

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