VP, Payment Integrity

1 hour, 18 minutes ago
Full-time
Executive
Operations
Gravie

Gravie

Gravie is reinventing health benefits with transparent, affordable solutions like Comfort® plan, ensuring easy access to care for employers and individuals.

Insurance
251-1K
Founded 2013
$177M raised

Description

  • Lead payment integrity strategy and execution across pre- and post-payment review programs, fraud prevention, and recovery efforts.
  • Design solutions to reduce claims leakage across the claims lifecycle, including internal capabilities and external vendor programs.
  • Assess the current payment integrity ecosystem and prioritize opportunities to deliver additional savings.
  • Build and manage a multi-vendor portfolio, enforce SLAs, and optimize contingency fee structures while mitigating provider abrasion.
  • Provide executive leadership for all payment integrity operations and ensure strong performance across internal and external programs.
  • Lead efforts to insource payment integrity opportunities where appropriate.
  • Establish, monitor, and report on 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 track savings from payment integrity initiatives in detail.
  • Build, mentor, and lead a high-performing leadership team with a culture of accountability, collaboration, and continuous improvement.

Requirements

  • 15+ years of progressive leadership experience in healthcare claims or payment integrity operations, including significant executive-level responsibility.
  • Deep expertise in medical claims operations, payment integrity, claims configuration, and regulatory compliance.
  • Experience scaling operational organizations in high-growth or complex environments.
  • Strong understanding of healthcare regulations, audit requirements, and industry best practices.
  • Experience leading large, distributed teams and managing complex vendor relationships.
  • Strong strategic, analytical, financial, and operational acumen.
  • Education, skills, work experience, certifications, and other factors may be considered when determining compensation.

Benefits

  • Salary range of $207,000 to $304,000 annually.
  • Eligibility for Gravie’s annual bonus program.
  • Stock options may be awarded as part of the compensation package.
  • Above-average total rewards package.
  • Flexible PTO.
  • Up to 16 weeks of paid parental leave.
  • Paid holidays.
  • 401(k) program.
  • Standard health and wellness benefits, including alternative medicine coverage.
  • Cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.

Interested in this position?

Apply directly on the company website

Apply Now

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