Assistant Vice President of Quality – Payment Integrity, Healthcare

Shape the future of Payment Integrity and Healthcare Quality Audits.
We’re hiring a dynamic Assistant Vice President (AVP) of Quality to lead and advance quality operations across clinical, coding, third party liability, and operational audits within Payment Integrity. Reporting to the Senior Assistant Vice President of Global Quality, you’ll provide strategic leadership to Quality Managers and their teams—ensuring every deliverable meets or exceeds internal KPIs, SLAs, and client expectations. 

This is a mission-critical role driving quality excellence, proactive risk mitigation, scalable quality operations, and continuous process improvement to support rapid growth. You’ll partner closely with Operations, Training, Technology, and global quality stakeholders to align processes, scale capabilities, and deepen knowledge across the organization.

If you’re a strategic, results-driven leader passionate about quality, innovation, and measurable impact, we want to hear from you.

What You’ll Lead

• Lead end-to-end healthcare quality operations for clinical, coding, TPL, and operational audits, ensuring accuracy, compliance, and operational excellence. 
• A team of Quality Managers and their teams, driving consistency in audit methodology, scoring standards, and governance.
• Quality strategy—short and long term—rooted in data-driven insights, risk identification, and process excellence.
• Cross-functional collaboration for global alignment to unify standards, scale solutions, and share best practices.

Quality Leadership & Outcomes

• Drive overall operational quality performance, to achieve accuracy standards, KPIs, SLAs, and exceed client expectations.
• Develop and mentor the quality leaders and team, fostering accountability, continuous improvement, and quality excellence. 
• Develop and oversee quality audit methodologies, scoring frameworks, and governance protocols, ensuring consistent and high-quality execution across all audit programs. 
• Proactively identify process risks and implement initiatives to enhance audit quality, leveraging audit data and trend analysis to improve quality outcomes.  
• Lead quality readiness for new programs, clients, and rapid growth, ensuring scalable processes. 

Process Improvement, Efficiency & Scalability

• Drive continuous improvement initiatives using root cause analysis, data analytics and process evaluation to enhance quality, efficiency, and scalability.
• Leverage trends and metrics to identify and drive automation and process improvements that optimize processes and outcomes. 
• Lead initiatives to automate processes and enhance efficiencies, driving improvements in audit quality, scalability, and organizational outcomes; partner with Technology to implement digital solutions.
• Design and oversee scalable repeatable processes, ensuring consistent execution and sustainable operational quality. 

Leadership & Talent Development

• Lead Quality Managers and their teams, providing guidance, mentorship, and coaching to consistently achieve goals, through high-quality audit performance. 
• Strengthen depth of knowledge across team, implementing calibration, coaching, and upskilling initiatives to align quality audit teams. 
• Drive a high-performing, accountable, quality-focused culture, modeling standards and reinforcing behaviors that elevate team and operations performance. 
• Cultivate a results-driven quality team, delivering insights, coaching, and guidance to operational areas, while recommending process improvements to drive consistent audit quality outcomes. 

Cross-Functional Collaboration and Global Alignment

• Partner with global quality leaders to align processes, metrics, and audit standards.
• Collaborate with Operations, Training, and Technology to drive improvements.
• Share best practices and insights across regions to ensure a unified approach.
• Lead and support change management initiatives and strategic quality projects.

Client, Metrics & Governance

• Oversee all operational quality performance, tracking KPI’s and performance metrics and leading actions plan to address gaps and drive improvement. 
• Deliver insight-driven reporting