Senior Manager of Payment Integrity

Job Summary

A company is looking for a Senior Manager, Payment Integrity- Provider Experience & Enablement.

Key Responsibilities

• Oversee escalated provider issue management, ensuring timely and accurate resolutions across teams
• Act as a liaison with Network and Health Plans to align Payment Integrity programs with provider impacts
• Develop provider-facing education and training materials to enhance understanding and adoption of Payment Integrity requirements

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business, Public Health, Health Information Management, or related field; Master's degree preferred
• 6+ years of experience in Payment Integrity, Health Plan Operations, or related fields
• 4+ years of leadership experience with direct reports
• 2+ years of experience with SIU/FWA investigations or fraud/waste mitigation
• Experience in developing provider-facing education and analyzing trends for operational improvements