Vice President of Audit Reimbursement & Recoupment

As a condition of employment physical work location must be in one of the 50 states or the District of Columbia.

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Vice President of Audit, Reimbursement, and Recoupment

The Vice President (VP) Audit, Reimbursement and Recoupment is responsible for providing executive-level oversight and administration of Provider Audit, Reimbursement, and Recoupment Division (PARRD) activities for the management, staff, and organization. This position supports corporate strategies while developing operational strategies to meet the current and future needs of the organization and serves as a member of the organization's executive leadership team. This position supports the expansion of PARRD services with existing and potential future customers in alignment with the growth strategy for the organization. This position ensures that PARRD is optimizing performance and maintaining contractual requirements, within approved budget and staffing levels.

• Establishes short and long-term strategies and goals for the Provider Audit, Reimbursement, and Recoupment division and works closely with other executive leaders to ensure alignment with the corporate strategy and overall business objectives.
• Accountable for the development, implementation, and maintenance of divisional and departmental plans. Directs business unit/area leaders with responsibility for operational planning and execution, contract negotiation, and resource allocation including budget and personnel.
• Establishes performance metrics, tracks key performance indicators, and implements corrective actions to ensure operational goals are met. Monitors goal progress and communicates the status with the senior leadership team.
• Oversees the effective allocation and utilization of resources, staffing, and tools. Leads improvements to enhance efficiency, reduce costs and improve overall operational performance in alignment with contract and corporate budgets and contractual obligations.
• Ensures the department has the tools, resources, and processes to capture robust and accurate data, to monitor and meet performance metrics, with clear line of sight for decision making.

Communication and Influence:

• Regularly communicates and collaborates with internal and external customers, including federal and state agencies, vendors, and other stakeholders to negotiate and coordinate the delivery of contracted services.
• Builds and maintains positive business relationships with employees, management, professional organizations, customers, vendors, and other external stakeholders, as well as entities with similar operational functions.
• Leads by example through influence and not position, representing the company in a positive and constructive manner in alignment with Noridian's values and behaviors.

Innovation & Complexity:

• Drives solutions and innovations that address changes in regulations and contract requirements with a proactive focus on the evolving needs of the customer and/or organization.
• Researches, recommends, implements and documents appropriate solutions to complex operational issues.
• Provides recommendations on matters relating to staffing, performance metrics, and service level agreement measures.

Leadership & Talent Management:

• Motivates and enables staff to reach their highest potential by fostering the continuous professional development and career growth of a diverse workforce, coaching, and mentoring future leaders, identifying and championing high potential talent, and creating high-performance teams while demonstrating creativity, flexibility, and willingness to embrace change.
• Leads organizational effectiveness, drives organizational change, and promotes talent development, employee engagement, and cultural transformation at all levels within the division by providing tools, resources, and opportunities for growth.
• Ensures high quality output by providing employees with learning opportunities, skill development, and training resources that supports adherence to operational policies and procedures and accountability to performance expectations.

Knowledge & Experience:

• Maintains comprehensive knowledge and awareness of trends, standards, and current events relative to financial accounting, reimbursement, and debt collection in the healthcare market.
• Utilizes knowledge of industry trends and regulations to guide strategic and operational decisions.
• Integrates data-driven insights and methodologies into operational planning and execution.
• Leads knowledge transfer initiatives to build organizational capacity and resilience.
• Leverages data and experience to anticipate future challenges and opportunities.

• Other duties as assigned

• BS/BA degree in accounting or business.
• 10 years' experience in health insurance operations. This includes 5 years' experience in leadership-level positions in operational systems and workflows related to finance, accounting, revenue, budgeting, and/or financial auditing.
• Demonstrated analytical and problem-solving skills.
• Proven ability to effectively engage and collaborate with stakeholders at all levels, including executive leadership and the Board of Directors.
• Demonstrated experience advising internal and external customers, producing data, and providing insights based on professional expertise and a comprehensive understanding of organizational impact.
• Skilled in presenting to, collaborating with, and making strategic recommendations to executive leadership and the Board of Directors.
• Expertise in strategic planning, budget development, and the implementation of operating plans to achieve organizational goals.
• Strong leadership skills with extensive experience in leading teams, driving results, and maintaining operational efficiencies. Ability to assemble, lead, and motivate a team of professionals to produce and improve outcomes.
• Highly adept at building and nurturing relationships, with strong organizational skills to manage multiple priorities effectively.

• MBA degree with a concentration in Accounting or Finance OR CPA.
• Experience with large complex projects, cost reporting, settlements, recoupment strategies, and regulatory changes.

• Office Environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone use
• Requires the use of office equipment such as computer terminals, telephones, copiers and printers
• Infrequent lifting to 15 pounds
• Infrequent stooping
• Travel Required

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

An employee in this position may be required to possess a "Federal Identification Card" (Federal ID) as a condition of employment. Federal ID's may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Below is the salary range for potential new hires.

Salary Range: The pay range for this position is $120,436.17 - $197,788.33 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Other Compensation: Incentive Plan & Lifestyle Benefit

This job will be closed 08/22/2025 at 8:00AM CST. No further applications will be considered.