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Our mission: to dramatically improve the health & well-being of older Americans by caring for everyone like family
Senior Payment Integrity Manager
Location
United States
Posted
108 days ago
Salary
$104.5K - $155K / year
Seniority
Senior
Job Description
Senior Payment Integrity Manager
Devoted Health
• Lead and optimize the execution of enterprise payment integrity initiatives, with accountability for performance across prepay and postpay claims review programs. • Translate organizational strategy into operational action plans, ensuring alignment with savings goals, audit integrity, and regulatory compliance. • Partner with analytics, finance, compliance, and tech to identify new audit opportunities, improve processes, and develop scalable solutions. • Oversee the health of audit pipelines by ensuring work inflow and outflow are properly forecasted, balanced, and executed. • Monitor program KPIs such as savings, throughput, adjustment timeliness, and audit yield. • Take corrective action when performance falls short. • Use data to identify root causes of inefficiencies or payment errors and lead the development of solutions to reduce future risk. • Serve as a senior escalation point for complex issues involving claims adjustments, provider disputes, and operational bottlenecks. • Collaborate with departments such as Claims, Appeals, Provider Relations, and Medical Management to troubleshoot issues and implement improvements across the payment life cycle.
Job Requirements
- Bachelor’s degree and 6+ years of professional experience in high-growth operations, strategy, or healthcare management
- Proven ability to drive alignment across departments (Operations, Product, Engineering) and manage up to senior leadership.
- An understanding of the US healthcare ecosystem.
- Ability to build a process where one doesn't exist and pivot gracefully when company needs shift
- Ability to use the company’s vision and values as a North Star when making operational trade-offs
- Proficiency with SQL
- Familiarity with agile methodologies or frameworks for managing complex, cross-functional initiatives
Benefits
- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
- Parental leave program
- 401K program
- And more....
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