Job Details

A company is looking for a Sr. Manager Payment Integrity - Health Plan Concierge.Key ResponsibilitiesProvide operational and strategic leadership for Payment Integrity activities, ensuring alignment with enterprise goalsCollaborate with various departments to address systemic issues, improve workflows, and enhance provider and member experienceDirect provider education and communication efforts, ensuring clear messaging and successful adoption of initiativesRequired QualificationsBachelor's degree in Healthcare Administration, Business, Public Health, or related field; Master's degree preferred6+ years of experience in Payment Integrity, claims operations, or managed care operations4+ years of leadership experience with direct reportsExperience with PI functions such as audits and analyticsStrong understanding of payment integrity concepts and regulatory requirements relevant to the line of business