Assistant Director, Payment Integrity & Policy Innovation

Cambia Health Solutions; Fargo (ND); Hybrid; USD 101,000 - 167,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

Wellness programs

Job summary

Cambia Health Solutions seeks an Assistant Director Integrity Policy & Implementation to lead reimbursement policy, coding dispute resolution, and affordability initiatives. You will direct policy development, oversee the Reimbursement Policy Committee, and shape enterprise-wide strategies with legal, compliance, and finance teams.

You will guide data infrastructure, vendor collaboration, and executive communications while mentoring a team of 3–6 direct FTEs and 40–60 total FTEs.

Qualifications

• Masters (or higher) in a health-related field required; public health or related field preferred.
• 7+ years of management or professional health care experience in a managed care system or equivalent.
• Strong policy, coding and operational understanding for reimbursement strategies.

Responsibilities

• Lead reimbursement policy, coding disputes, and PI ideation initiatives.
• Develop budgets, policies, workflows, and change plans with leadership teams.
• Oversee Reimbursement Policy Committee and cross-enterprise coordination.
• Direct innovation and coding disputes to advance affordability initiatives.
• Provide long-term roadmaps for reimbursement policy and CI strategies.
• Ensure governance, risk management, and timely deliverables across work streams.

Skills

Policy strategy

Healthcare economics

Leadership

Policy implementation

AI tools experience

Education

Master's degree in health-related field

Master's in public health / business related field preferred

Tools

Policy governance tools

Job description

Cambia Health Solutions seeks an Assistant Director Integrity Policy & Implementation to lead reimbursement policy, coding dispute resolution, and affordability initiatives. You will direct policy development, oversee the Reimbursement Policy Committee, and shape enterprise-wide strategies with legal, compliance, and finance teams.

You will guide data infrastructure, vendor collaboration, and executive communications while mentoring a team of 3–6 direct FTEs and 40–60 total FTEs.