Director of Payment Integrity

A company is looking for a Director of Payment Integrity.

Key Responsibilities

Develop and implement payment integrity strategies and capability roadmaps to enhance operational efficiency and cost containment

Oversee payment integrity business processes, ensuring compliance with regulatory requirements and achieving annual savings targets

Manage vendor partnerships and lead performance management initiatives to monitor and improve service quality

Required Qualifications

Bachelor's degree or equivalent experience, with 8+ years in the healthcare setting and 5+ years in leadership roles

At least 10 years of experience in medical claims payment cost containment or payment integrity

Clinical and / or healthcare claims operational experience is strongly preferred

Experience in IT capability development for operational solutions

Proven ability to develop and implement strategies and manage multi-year operational plans