Vice President Payment Integrity and Verification Solutions

Summary

The VP, Payment Integrity and Verification Solutions is responsible for developing high quality business strategies and operational plans ensuring alignment with Gainwell short-term and long-term objectives for the solution offering. Partnering with product management, and leading delivery operations and business activities to ensure they produce the desired results and are consistent with the overall product line goals driving revenue growth, margin expansion and client satisfaction. The VP should be able to lead and motivate team members to advance employee engagement, develop a high performing managerial team along with partnering cross functionally with broader organization such as Finance, Account Management, Sales and Engineering.  

Your role in our mission

• Payment Analytics, FraudCapture, Credit Balance, Long Term Care, and Verification Solutions (dependent eligibility, residency verification, and community engagement verification).
• Partner with product organization on product development strategy and leading delivery execution within PI and verification solutions portfolios.
• Partner with product organization to ensure appropriate product roadmap and collateral documentation is available supporting PI and verification solutions products and communicating product strategy to the organization.
• Co-Develops appropriate business cases with product organization to obtain funding necessary for new product development.
• Responsible for developing, managing and attaining revenue and expense budget goals.
• Manages overall product portfolio integration to the recurring revenue budgeting and forecasting process.
• Responsible for systems that identify and mitigate opportunities/risks to the PI and verification solutions revenue portfolio.
• Advanced financial analysis and forecasting techniques to project and optimize revenue.
• Tracking of opportunities for product expansion and measures product yield in support of annual product revenue expansion targets.
• Lead operations team on demand and capacity planning, and assuring compliance with client SLAs and contract requirements.
• Oversee reviews of RFPs and new business proposals to assure they meet appropriate guidelines for strategic fit as well as implementation, operational and financial success.
• Improves product quality through a structured process of defect identification, root cause analysis, and corrective action project management.  
• Improves internal product and operational processes through deployment of Lean or other continuous quality improvement methodologies and principles.  
• Partner with implementation team accountable for solution architecture and project management of new implementations.    
• Participates with Solution Area Leader in communicating product strategy, financial results, operational status and quality/compliance issues to company leadership. 
• Leads PI and verification product teams by developing an environment of engagement and participation by all team members through regular communication and recognition. 
• Directs development and training of leadership skills within the team to assist team members in increasing their skill sets, developing bench strength and appropriate success plans. 

What we're looking for

• Bachelor’s degree in business field is required. Master's degree in business or related field is preferred
• At least fifteen years of gradually increasing product, finance and/or operational leadership experience 
• Experience working within the healthcare industry required, experience with Medicaid, payment integrity and verification solutions strongly preferred 

What you should expect in this role

• This opportunity is 100% remote with the opportunity to travel up to 25% annually.

The deadline to submit applications for this posting is December 12, 2025.