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Program Director – WTC Health Program, COB & Recovery Program
Location
United States
Posted
78 days ago
Salary
0
Seniority
Lead
Job Description
Program Director – WTC Health Program, COB & Recovery Program
Simsy Ventures
• Serve as the primary liaison between the organization and the WTC Health Program, including communication with Program Management, Contracting Officer (CO), and Contracting Officer Representative (COR) • Provide end-to-end oversight of contract operations, ensuring all deliverables meet quality, timeliness, and compliance standards • Lead execution of a comprehensive cost avoidance, COB, and recovery program across pre- and post-payment processes • Ensure accurate and timely submission of reports, deliverables, and ad hoc requests • Oversee implementation and adherence to a robust quality assurance program • Manage cross-functional teams supporting: • Insurance identification and verification • Coordination of benefits (COB) • Claims recovery (OHI & Workers’ Compensation) • Payment integrity and fraud, waste, and abuse (FWA) efforts • Maintain effective communication channels with internal staff and external stakeholders, including government entities and program partners • Drive performance monitoring, operational improvements, and cost containment strategies • Ensure compliance with federal regulations, HIPAA requirements, and contractual obligations • Foster and maintain strong business relationships with all program stakeholders
Job Requirements
- Minimum 10+ years of experience in:
- Coordination of Benefits (COB)
- Claims recovery / payment integrity
- Federal healthcare program management
- Proven experience managing large, complex government contracts or programs
- Strong knowledge of:
- Healthcare claims processing
- Insurance coordination (OHI, Workers’ Compensation)
- Payment integrity and recovery operations
- Demonstrated leadership experience managing cross-functional teams and stakeholders
- Experience ensuring contract compliance, reporting accuracy, and SLA performance
- Excellent communication and stakeholder management skills.
Benefits
- 100% remote/offsite
- Occasionally travel (estimated 4+ trips annually)
- Travel may include Washington, DC; New York City; Cincinnati; Atlanta
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