Payment Integrity Business Partner

Job Summary

Serving as a primary liaison for assigned health plans, the full-time remote Payment Integrity Business Partner will manage relationships, facilitate issue resolution, and communicate program performance to ensure alignment with business objectives.

Key responsibilities

• Act as the main point of contact for health plans and stakeholders regarding Payment Integrity programs and initiatives
• Build and maintain relationships with market leadership, providers, and vendors to support effective communication and alignment
• Analyze performance metrics to identify opportunities for improving payment accuracy and operational effectiveness

Required qualifications

• Bachelor's degree with 2-4 years of related experience in healthcare operations, managed care, or payment integrity
• 3+ years of experience in claims operations, provider relations, or vendor management
• Experience collaborating with cross-functional teams and presenting updates to leadership
• Preferred experience in Medicare, Medicaid, or Marketplace operations
• Certification as a Project Management Professional (PMP) or Lean Six Sigma is strongly preferred