Confidential · 19 hours ago
VP, Medicare Advantage Revenue Integrity
United States
Full-time
Remote
Director/Executive
10+ years expConfidential company is entering an exciting visionary phase of growth and seeking a Vice President of Medicare Advantage Revenue Integrity. The role involves safeguarding and enhancing Medicare Advantage revenue while collaborating across departments to drive improvements in capitation accuracy and financial performance.
Marketing & Advertising
Responsibilities
Own the enterprise revenue integrity strategy across all MAPD and DSNP members
Establish and manage a multi-year roadmap to eliminate systemic revenue leakage and ensure CMS payment accuracy
Advise executive leadership on operational opportunities and forecasted revenue impacts
Lead a high-performing team across analytics and operations
Maintain KPIs, dashboards and audit programs to measure financial impact and throughput
Implement technology enabled workflows
Oversee applicable external relationships
Quantify revenue opportunities and deliver a predictable, auditable financial impact
Partner with actuarial and finance to forecast uplift tied to revenue integrity efforts
Ensure all internal processes remain aligned with CMS guidance
Qualification
Required
A Medicare Advantage Maven – 10+ years of experience in Medicare Advantage with direct ownership of payment integrity or revenue integrity operations. You know the landscape inside and out and can navigate CMS payment policies with precision
A Policy Powerhouse – Deep understanding of CMS payment processes and the ability to amend errors with confidence. You're the go-to expert when accuracy matters most
A Revenue Impact Driver – Proven ability to deliver measurable financial results and operational improvements. You don't just manage processes, you transform them
A Cross-Functional Influencer – Skilled at managing teams and influencing senior executives. You thrive in complex environments and know how to bring people together to achieve big goals
An Analytical Architect – Strong analytical and process design capabilities. You see patterns others miss and build systems that scale
Preferred
A Builder of Integrity – Experience managing or building revenue integrity operations from the ground up
A Strategic Partner – Prior leadership in actuarial, finance, or government programs
A Relationship Manager – Ability to manage external partners and align them to organizational goals
Company
Confidential
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Silicon Valley, California US, US
51-200 employeesFunding
Current Stage
Growth StageLeadership Team
Roshan Syed
Global Talent Partner
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