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Alka Vardhan

@alkavardhan

Senior Healthcare Analytics leader driving payment integrity, risk adjustment, and program governance to improve operational outcomes.

India

Message

What I'm looking for

I’m looking to lead healthcare analytics and PMO programs that modernize payment integrity and risk adjustment with Generative AI/NLP, with strong governance, cross-functional alignment, and measurable operational excellence—while mentoring teams through transitions.

I’m a Senior Manager in Healthcare Analytics with 23+ years across healthcare operations, analytics, and program management. I specialize in payment integrity transformation, Medicare risk adjustment, revenue cycle management, and fraud, waste & abuse (FWA) analytics—always with a structured, data-driven approach to execution.

I lead PMO governance and reporting to align business and technology teams for measurable results. I’ve redesigned 20+ payment integrity workflows using pain-point-to-solution frameworks, helped translate complex data into actionable insights, and built governance structures that keep delivery predictable across analytics and operations.

On risk adjustment and FWA, I’ve combined RA/HCC domain expertise with NLP-enabled ideas to support digital transformation. I’ve spearheaded post-payment review analytics to detect claims anomalies and overpayments, and I’ve strengthened denial management and coding interventions to improve collections and reduce AR.

I also enjoy building capability during global transitions—leading offshore transitions, mentoring teams (65+), and stabilizing go-live operations. From outlier and variance analytics to KPI-led RCM improvements, I bring the same theme: process transformation, strong stakeholder management, and practical analytics that create real operational outcomes.

Experience

Work history, roles, and key accomplishments

Current

Senior Manager – Healthcare Analytics

Current

EXL

Aug 2012 - Present (13 years 11 months)

Led healthcare analytics programs across payment integrity and Medicare risk adjustment, including redesign of 20+ workflows to improve efficiency. Delivered PMO governance and stakeholder alignment across analytics, operations, and technology, and drove fraud/waste/abuse analytics and revenue cycle improvements.

Excel Healthcare Analytics Payment Integrity Fraud Waste and Abuse (FWA) Analytics Denial Management KPI Management Stakeholder Management SQL SAS Tableau Power BI MS Word Generative AI NLP Revenue Cycle Management

Accounts Receivable Manager

Masan Global Services

Feb 2011 - Mar 2012 (1 year 1 month)

Managed accounts receivable operations in a new geography by leading a 65+ member team and applying KPI-led governance to improve collections discipline and delivery performance.

Accounts Receivable Collections Program Governance

Manager – Training, Healthcare

Genpact

May 2010 - Dec 2010 (7 months)

Designed and delivered structured training programs for healthcare operations teams to improve readiness, knowledge transfer, and performance during transitions and ramp-ups.

Training Program Design Knowledge transfer

Assistant Manager / Team Lead – RCM

Apollo Health Street Limited

Aug 2004 - May 2010 (5 years 9 months)

Drove revenue cycle management improvements by reducing AR days and increasing collections through denial follow-up and resolution. Led operational transitions, trained teams on systems/workflows, and supported credit balance and self-pay/bad address initiatives.

Denial Management Collections AR Days Reduction Patient Calling Operations Transition (US To India)Credit Balances Revenue Cycle Management