Director of Payment Integrity Solutions

Job Summary

Seeking an experienced clinical Payment Integrity (PI) leader, the full-time Director of Payment Integrity Solutions will manage client implementations, provide expert workflow consulting, and deliver clinical demonstrations, all while working remotely.

Key Responsibilities

• Lead end-to-end client implementations of claims and payment integrity solutions, ensuring successful go-live and measurable impact
• Act as a trusted advisor to clients, diagnosing workflow challenges and providing guidance on leveraging AI-driven tools for clinical validation
• Deliver high-impact demonstrations and presentations, showcasing AI capabilities and tailoring discussions to client pain points

Required Qualifications

• 8+ years of experience in healthcare payment integrity with significant clinical review or leadership experience
• Proven ability or strong desire to engage with clients, including experience presenting to executives and leading demos
• Track record of successfully leading complex claims or PI solution implementations
• Strong clinical background (RN or equivalent) and familiarity with AI-enabled tools in payment integrity
• Excellent communication skills with the ability to translate complex concepts for diverse audiences