Director of Payment Integrity

Job Summary

A company is looking for a Director of Payment Integrity - Health Plan Concierge.

Key Responsibilities

• Provide operational and strategic leadership for Payment Integrity activities within the assigned line of business
• Execute program strategies to reduce improper payments and enhance claims accuracy
• Collaborate with various departments to address systemic issues and improve workflows

Required Qualifications

• Bachelor's degree in Healthcare Administration, Nursing, Finance, Accounting, Business, Operations Management, or a related field; Master's degree preferred
• 8+ years of experience in Payment Integrity, claims operations, or managed care operations
• 3+ years of experience with Payment Integrity functions such as audits and analytics
• Demonstrated experience working cross-functionally with various departments
• Strong understanding of payment integrity concepts and regulatory requirements