Company Overview and Culture 

EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com.

For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses. 

About EXL Health

We leverage Human Ingenuity and domain expertise to help clients improve outcomes, optimize revenue and maximize profitability across the healthcare ecosystem.  Technology, data and analytics are at the heart of our solutions.  We collaborate closely with clients to transform how care is delivered, managed and paid.  

EXL Health combines deep domain expertise with analytic insights and technology-enabled services to transform how care is delivered, managed, and paid.  Leveraging Human Ingenuity, we collaborate with our clients to solve complex problems and enhance their performance with nimble, scalable solutions.  With data on more than 260 million lives, we work with hundreds of organizations across the healthcare ecosystem.   

We help payers improve member care quality and network performance, manage population risk, and optimize revenue while decreasing administrative waste and reducing health claim expenditures. We help Pharmacy Benefit Managers (PBMs) manage member drug benefits and reduce drug spending while maintaining quality. We help provider organizations proactively manage risk, improve outcomes, and optimize network performance. We provide Life Sciences companies with enriched data, insights through advanced analytics and data visualization tools to get the right treatment to the right patient at the right time.

EXL Health is looking for an AVP of Payment Integrity Administrative Operations. This is 100% remote work from home opportunity!

Are you an experienced Payment Integrity leader looking for the next step in your career path? Is it time for a change? Explore this opportunity with a new, exciting, and dynamic growth-oriented team.

In this role you will collaborate with a diverse group of Payment Integrity Audit Program leaders, and manage the day-to-day administrative operations and administrative operational team members to ensure we are compliant with client requirements.

The successful candidate will be passionate, quality focused and have a diverse background in all types of payment integrity audits. The person will also collaborate with other areas to identify and work on resolution for areas of potential risk or concern that impede optimal recovery results. We are looking for someone who is passionate about Payment Integrity, and a desire to work in an environment that thrives on teamwork, excellence, collaboration, inclusiveness, and support.

Responsibilities:

• Support work environment to facilitate employee satisfaction, people development, continuous process improvement, quality, productivity, and client satisfaction.
• Capable of building and maintaining strong interdepartmental working relationships
• Support operational projects and activities to drive process improvement which may include participation in technical/business discovery conversations, completion of root cause analysis to identify and solve for operational challenges/barriers to program success.
• Collaborate with Finance and client on open and aging Collections.
• Routine review of Compliance Checklist and ongoing review and updates
• Create and manage Provider or Client Remediation Plans as required.
• Collaborate with EXL Compliance teams to ensure ongoing compliance and documentation.
• Maintain required operational documentation, Organizational charts, Team training documents.
• Collaborate with Client Engagement Manager and Audit Program managers to respond to provider or client requests.
• Work with team members to problem solve aging inventory or other operational issues.
• Assist with creating and maintaining Statement of Policy (SOP) to ensure compliance with client Statement of Work as well as with compliance of internal policies and procedures, external regulations, and information security standards.

Qualifications:

• 10+ years’ experience in Payment Integrity with Complex & Automated Audit & Recovery programs preferred.
• 5+ years of Senior level management experience with preference for remote management for a diverse group of Payment Integrity professionals.
• Strong project management, and analytical skills, with attention to detail
• Strong leadership skills, with the ability to develop work plans, action plans, and standard operating procedures.
• Regulatory compliance experience preferred
• Excellent oral and written communication skills
• Strong relationship building skills.
• Advanced skills in Word, Excel, and PowerPoint

Education and Required Certification:

• Bachelor’s degree Required.
• Master’s degree Preferred.

What We Offer:

• EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions. From your very first day, you get an opportunity to work closely with experienced, world class Healthcare consultants.
• You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth.
• We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
• Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.
• Benefits we offer are Healthcare, Vision, Dental and 401k options.