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. Responsibilities 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 to senior leadership and stakeholders, highlighting trends, performance gaps, and strategic opportunities to enhance quality outcomes. - Drive implementation of improvement plans based on audit insights, enhancing operational quality, consistency, and performance across both the quality team and all audit programs. - Establish and maintain SOPs, governance frameworks, and documentation ensuring they are current, effective and consistently applied.  Qualifications Essential Functions - Lead Quality Managers And their teams, providing guidance, mentorship, and coaching to ensure consistence performance and achievement of goals. - Oversee operational quality performance, ensuring audit programs consistently meet or exceed KPI's, SLAs, and quality standards. - Manage capacity planning, productivity, and workload distribution within the  quality team.  - Drive quality performance, risk mitigation, and continuous improvement initiatives, translating audit insights into measurable audit outcomes.  - Ensure alignment of quality standards across programs and global regions, promoting consistency, best practices, and operational quality excellence.   Education & Experience 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 proven leadership experience managing quality teams in complex, fast-paced environments. - Expertise in quality methodologies and process improvement (Lean, Six Sigma, etc.). - Experience with audit tools, dashboards, reporting systems, and advanced Excel. Skills & Competencies - Strong analytical, strategic thinking, and problem-solving abilities; able to turn insights into action. - Exceptional verbal, written, and presentation communication skills. - Ability to drive operational excellence while maintaining quality standards. - Digital mindset with a knack for automation and scalable solutions. - Collaborative leadership style—able 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. Key Success Indicators - Consistent achievement of quality KPIs and client SLAs. - Proactive risk identification and mitigation. - Scalable, efficient quality operations supporting growth. - Increased knowledge depth across quality and operational teams. - Strong cross-functional and global alignment. - High levels of client and stakeholder satisfaction. What We Offer - An exciting, fast-paced, and innovative environment with sharp, entrepreneurial professionals eager to influence business decisions. - From day one, work closely with highly experienced, world-class Healthcare consultants. - Learn diverse aspects of our clients’ businesses while developing teamwork and time-management skills—key for personal and professional growth. - Mentorship & coaching through our program: junior-level employees are paired with senior-level advisors. - Limitless growth—the unique experiences at EXL Health set the stage for advancement within the company and beyond. Ready to Make an Impact? Bring your leadership, insight, and innovation—and help us raise the bar for healthcare quality and Payment Integrity. Apply today and lead a high-performing organization that delivers measurable results. Salary range for this role is $130k - $145k For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits About Company EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals. Company EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.