Assistant Director, Payment Integrity & Policy

Cambia Health Solutions; Medford (OR); Hybrid; USD 122,000 - 165,000; Full time

Benefits offered by this job

Health insurance

Dental and vision coverage

401(k) with company match

Paid time off varies by role

Parental leave (up to 12 weeks)

Wellness programs

Employee assistance fund

Remote/work-from-home options

Job summary

Cambia Health Solutions is seeking an Assistant Director Integrity Policy & Implementation to lead reimbursement policy, coding disputes, and Payment Integrity initiatives. You will develop strategy, supervise teams, and coordinate across legal, compliance, and healthcare informatics to drive affordable, person-focused care.

You will manage policy development, governance, and cross-enterprise collaboration, guiding budgets, workflows, and change management while maintaining results and

Qualifications

• Masters (or higher) degree in a health-related field required.
• Masters in public health, business administration, public administration, or related field desired.
• Minimum of seven years of management or professional business experience in a managed health care system, medical group, hospital, or related business in health care delivery industry or equivalent experience.

Responsibilities

• Lead strategic planning and execution of reimbursement policy, coding disputes, and Payment Integrity ideation initiatives, including program tracking, financial justification, and prioritization.
• Provide vision, direction, and leadership to teams by developing budgets, policies, workflows, and change management plans while monitoring results and metrics.
• Oversee the Reimbursement Policy Committee to ensure proposed policies are operational and vetted across all enterprise stakeholders.
• Direct innovation teams and coding disputes resolution to develop and execute new affordability initiatives across all tools and levers.
• Leverage knowledge of health plan operations and industry trends to provide strategic roadmaps for reimbursement policy and Payment Integrity strategies.
• Maintain program governance by driving accountability, escalation of issues, and clear communication of requirements to work streams.
• Direct data infrastructure enhancements and IT infrastructure needs, developing team KPIs and participating in RFP processes.

Education

Master's degree in a health-related field

Job description

Cambia Health Solutions is seeking an Assistant Director Integrity Policy & Implementation to lead reimbursement policy, coding disputes, and Payment Integrity initiatives. You will develop strategy, supervise teams, and coordinate across legal, compliance, and healthcare informatics to drive affordable, person-focused care.

You will manage policy development, governance, and cross-enterprise collaboration, guiding budgets, workflows, and change management while maintaining results and