Director of Payment Integrity

Job Summary

A company is looking for a Director, Payment Integrity Strategy and Operations.

Key Responsibilities

• Develop and oversee the strategy for Payment Integrity programs focused on cost of care and payment accuracy
• Coordinate process improvements and manage internal teams to enhance PI models and provider engagement
• Represent the Payment Integrity department in internal and external meetings, driving innovation and collaboration efforts

Required Qualifications

• Bachelor's degree and 10 years of experience in reimbursement policy or provider reimbursement
• Direct health plan experience is required
• Experience in business case development and financial analysis
• 7 years of leadership experience managing teams or complex projects
• Familiarity with Payment Integrity products and solutions is preferred