Director of Payment Integrity

Job Summary

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

Key Responsibilities

• Develop and oversee strategies for Payment Integrity programs focused on cost of care and payment accuracy
• Manage project planning and performance evaluation, including setting KPIs and developing business cases
• Coordinate process improvements and collaborate with internal and external stakeholders on reimbursement policies

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 in managing teams or complex projects
• Preferred experience with Payment Integrity products and strategic frameworks