Director of Payment Integrity

Job Summary

A company is looking for a Director of Payment Integrity.

Key Responsibilities

• Lead the strategic planning, development, and execution of a comprehensive Payment Integrity program
• Oversee operational processes, establish procedural standards, and manage internal teams and vendor relationships
• Monitor performance trends and collaborate with stakeholders to drive operational and technical enhancements

Required Qualifications, Training, and Education

• Bachelor's degree or equivalent combination of education and experience
• 10+ years of relevant experience in Payment Integrity or Payer Operations
• 7+ years specifically in Payment Integrity
• Experience with vendor oversight and leadership reporting
• Preferred experience with Epic Tapestry claims system and Medicare/Medicaid Managed Care programs