AVP Program Integrity - Ideation and Analytics

Job description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries. The AVP of Program Integrity will lead the strategy, execution, and continuous improvement of pre-pay and post-pay audit concepts. This leader brings deep payer-side expertise, strong clinical and coding knowledge, and the ability to translate regulatory and payer policies into scalable and profitable audit logic. The role partners with Audit Operations, IT, Sales, and Client Leadership to expand Sagility's end-to-end Payment Integrity value proposition, ensuring industry-leading medical cost savings, operational excellence, high quality, and strong client trust. Job title: AVP Program Integrity - Ideation and Analytics Job Description: Operational Leadership - Direct multi-disciplinary PI teams including Ideation SMEs, Pricing Analysts, aud...