Assistant Vice President – Quality, Payment Integrity, Healthcare
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Job Description
AVP leading payment integrity quality operations and healthcare audits at EXL, a data analytics and digital operations company. Managing quality teams, risk mitigation, process improvement, and global alignment.
Responsibilities:
- 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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