Payment Integrity Manager

Job Summary

A company is looking for a Sr. Manager Payment Integrity - Health Plan Concierge.

Key Responsibilities

• Provide operational and strategic leadership for Payment Integrity activities, focusing on provider engagement and issue resolution
• Execute program strategies to reduce improper payments and enhance claims accuracy while supporting financial objectives
• Collaborate with various departments to resolve systemic issues and improve provider and member experience

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business, Public Health, or related field; Master's degree preferred
• 6+ years of experience in Payment Integrity or managed care operations
• 4+ years of leadership experience with direct reports
• Experience working cross-functionally with various departments to resolve provider challenges
• Strong understanding of payment integrity concepts and regulatory requirements