About Alaffia & Our Mission
Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We're here to change that paradigm.
Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. With Alaffia, health plans can cut wasted spending more effectively than ever — and provide their members the most affordable care.
We're a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone.
About the Role & What You'll Be Doing
We're looking for a Payment Integrity (PI) leader who can take health plan clients from signed contract to successful go-live, and who knows PI well enough to design the solution and then deliver it. As Director, PI Solutions (Implementations), you will own client implementations end to end, shape how our AI platform and managed services are configured around real PI workflows, and build the repeatable playbook that lets us scale.
Client implementation demand is growing fast, and this role is central to our ability to deliver. You'll work closely with Operations, Product, Engineering, and Client Services, and act as a trusted advisor to client stakeholders throughout onboarding.
Your Responsibilities
Lead client implementations from kickoff through go-live and stabilization, including scoping, requirements gathering, workflow configuration, testing, and launch
Translate client PI programs (pre-pay, post-pay, clinical editing, DRG validation, overpayment recovery) into effective configurations of Alaffia's platform
Build and refine our implementation playbook, templates, and best practices, especially for health plan environments
Serve as the senior client contact during onboarding, including executive updates, risk management, and expectation setting
Partner with Operations, Product, Engineering, and Clinical teams to resolve blockers and turn client feedback into product and process improvements
Hand off cleanly to Account Management and Client Services, and identify opportunities to expand use of Alaffia's AI tools within client environments
Join late-stage sales conversations to scope implementation approach, timelines, and feasibility
Mentor and develop implementation and solutions team members
What We're Looking For
8+ years in healthcare payment integrity at a health plan or PI vendor, with strong knowledge of claims review, coding validation (DRG, CPT), and how improper payments are identified and recovered
Proven track record leading complex claims, PI, or healthcare technology implementations, from requirements through go-live (health plan implementation experience strongly valued)
Experience managing executive-level client relationships and communicating clearly through risk, delays, and change
Strong project and program management skills, including managing multiple concurrent implementations
Comfort with AI-enabled tools, claims platforms, or automation, and credibility with both PI operators and engineers
Excellent written and verbal communication
Demonstrated success driving savings, improving accuracy, or scaling PI programs
Nice to have:
Experience with agentic AI or transparent clinical AI in healthcare claims
Background in health plan operations, utilization management, appeals, or SIU
Experience building an implementation function or playbook at a growth-stage company
Familiarity with CMS and state/federal compliance, and common PI issues like upcoding, unbundling, and coordination of benefits
Our Culture
Alaffia was born out of our founders' personal connection to the inefficiency of the U.S. healthcare system. We are deeply mission-driven, with an abiding belief that technology can help create a better future for everyone — and we're looking for others who share our passion for change to join the team.
What Else Do You Get Working With Us?
Competitive Compensation
Medical, Dental, and Vision benefits
Flexible, paid vacation policy
Work in a flat organizational structure — direct access to Leadership
Skills Required
- 8+ years of experience in healthcare payment integrity at a health plan or payment integrity vendor
- Strong knowledge of claims review and coding validation, including DRG and CPT
- Experience identifying and recovering improper payments
- Track record leading complex claims, payment integrity, or healthcare technology implementations from requirements through go-live
- Health plan implementation experience
- Experience managing executive-level client relationships
- Strong project and program management skills, including managing multiple concurrent implementations
- Comfort with AI-enabled tools, claims platforms, or automation
- Ability to communicate effectively with payment integrity operators and engineers
- Excellent written and verbal communication skills
- Demonstrated success driving savings, improving accuracy, or scaling payment integrity programs
- Experience with agentic AI or transparent clinical AI in healthcare claims
- Background in health plan operations, utilization management, appeals, or SIU
- Experience building an implementation function or playbook at a growth-stage company
- Familiarity with CMS and state or federal compliance
- Familiarity with payment integrity issues such as upcoding, unbundling, and coordination of benefits
Alaffia Health Compensation & Benefits Highlights
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Healthcare Strength — Feedback suggests employer-paid medical, dental, and vision premiums for employees are a standout feature, with coverage consistently cited across the company’s materials and third-party listings. Some notes indicate contributions toward dependents, adding to perceived value even without full plan details.
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Leave & Time Off Breadth — Feedback suggests flexible/unlimited PTO and generous parental leave are repeatedly advertised and echoed by external profiles. These policies are viewed as modern and supportive, though exact parental-leave duration is not publicly specified.
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Retirement Support — Feedback suggests a 401(k) available from day one with traditional and Roth options enhances total rewards. Immediate eligibility is convenient, even though any employer match is not publicly disclosed.
Alaffia Health Insights
What We Do
Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that paradigm. Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire claims lifecycle. With Alaffia, health plans can cut wasted spending more effectively than ever and provide their members the most affordable care. We’re a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone.
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Alaffia Health Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
We have a recognize the varying needs of our employees and have designed a location-based policy, offering flexibility while ensuring that the hybrid work model supports both individual and company success.
