Assistant Vice President – Quality, Payment Integrity, Healthcare

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee comprehensive healthcare quality operations for clinical, coding, third-party liability, and operational audits.

• Lead Quality Managers and their respective teams, offering guidance, mentorship, and coaching.

• Monitor operational quality performance in relation to KPIs, SLAs, and established quality standards.

• Manage capacity planning, productivity, and the allocation of workload within the quality team.

• Develop and supervise quality audit methodologies, scoring frameworks, and governance protocols.

• Identify potential process risks and implement enhancements through the analysis of audit data and trends.

• Lead quality readiness initiatives for new programs, clients, and periods of rapid growth.

• Foster continuous improvement via root cause analysis, data analytics, and process evaluation.

• Spearhead automation and efficiency initiatives in collaboration with Technology.

• Design and oversee scalable, repeatable quality processes.

• Collaborate with global quality leaders, Operations, Training, and Technology teams.

• Drive change management initiatives and strategic quality projects.

• Monitor KPIs and performance metrics, providing insight-driven reports to senior leadership and stakeholders.

• Establish and uphold SOPs, governance frameworks, and documentation.

⛳️ Requirements

• Bachelor’s degree in healthcare, business, or a related field (advanced degree preferred).

• 7–10+ years of experience in healthcare quality operations, clinical/coding auditing, or payment integrity programs.

• 7–10+ years of demonstrated leadership experience managing quality teams in complex, fast-paced environments.

• Proficiency in quality methodologies and process improvement techniques, including Lean and Six Sigma.

• Familiarity with audit tools, dashboards, reporting systems, and advanced Excel.

• Strong analytical, strategic thinking, and problem-solving skills.

• Exceptional verbal, written, and presentation communication abilities.

• Capacity to drive operational excellence while upholding quality standards.

• Digital mindset focused on automation and scalable solutions.

• Ability to align multiple teams and collaborate with global partners.

• Excellent time management, prioritization, and stakeholder management skills.

• Proven capability to coach, develop, and inspire high-performing professionals.

• Dedication to continuous learning and fostering a culture of quality excellence.

🏝️ Benefits

• Dynamic, fast-paced, and innovative work environment.

• Collaborate closely with highly skilled, world-class Healthcare consultants.

• Gain insights into various aspects of clients’ businesses.

• Participate in a mentorship and coaching program that pairs junior-level employees with senior-level advisors.

• Opportunities for limitless growth and advancement within the company and beyond.