Assistant Vice President – Quality, Payment Integrity, Healthcare

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $130k - $145k / year

⏰ Full Time

🔴 Lead

👔 Vice President

👻 Ghost score 4%

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Logo of EXL

EXL

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• Lead end-to-end healthcare quality operations for clinical, coding, third-party liability, and operational audits • Lead Quality Managers and their teams, providing guidance, mentorship, and coaching • Oversee operational quality performance against KPIs, SLAs, and quality standards • Manage capacity planning, productivity, and workload distribution within the quality team • Develop and oversee quality audit methodologies, scoring frameworks, and governance protocols • Identify process risks and implement improvements using audit data and trend analysis • Lead quality readiness for new programs, clients, and rapid growth • Drive continuous improvement through root cause analysis, data analytics, and process evaluation • Lead automation and efficiency initiatives with Technology • Design and oversee scalable, repeatable quality processes • Partner with global quality leaders, Operations, Training, and Technology • Lead change management initiatives and strategic quality projects • Track KPIs and performance metrics and deliver insight-driven reporting to senior leadership and stakeholders • Establish and maintain SOPs, governance frameworks, and documentation

🎯 Requirements

• Bachelor’s degree in healthcare, business, or 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 proven leadership experience managing quality teams in complex, fast-paced environments • Expertise in quality methodologies and process improvement, including Lean and Six Sigma • Experience with audit tools, dashboards, reporting systems, and advanced Excel • Strong analytical, strategic thinking, and problem-solving abilities • Exceptional verbal, written, and presentation communication skills • Ability to drive operational excellence while maintaining quality standards • Digital mindset with automation and scalable solutions • Ability to align multiple teams and global partners • Strong time management, prioritization, and stakeholder management skills • Demonstrated ability to coach, develop, and inspire high-performing professionals • Commitment to continuous learning and a culture of quality excellence

🏖️ Benefits

• Exciting, fast-paced, and innovative environment • Work closely with highly experienced, world-class Healthcare consultants • Learn diverse aspects of clients’ businesses • Mentorship and coaching program pairing junior-level employees with senior-level advisors • Limitless growth and advancement within the company and beyond

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