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Manager – Client Success & Delivery at Innoquest Consulting
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AVP - Healthcare Payment Integrity (12-20 yrs)
Shift: US Shift/Work from Office
Mandatory ask: 12-20 years overall US Healthcare experience with minimum of 7-10 years in Payment Integrity.
Role Profile:
- As an Ops Leader manage large US Healthcare teams of 500-1000.
- Oversee the accurate and timely processing of healthcare claims, ensuring adherence to relevant payment policies, contractual obligations, and industry standards.
- Exceptional in PI domain and understands the entire landscape of PI as a market (Claims and Clinical).
- Identify opportunities to reduce healthcare costs through improved payment integrity processes, such as targeted audits, recovery efforts, and cost containment measures.
- P&L Management (Revenue management, Cost Optimization, Improvements).
- Identifying Transformational Value Creation via RPA and Analytics offerings.
- Track program performance and its impact on the financial goal.
- Delivering Highest Level of Service Delivery requirements.
- Mentoring & Coaching Operational & Leadership values.
- Creating strong client partnerships
- Exposure, experience and knowledge of Medical Coding, Nursing (NCLEX) and customer outreach experience.
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