Implementation Lead: Healthcare Claims & Payment Integrity

Alaffia Health; United States; On-site; USD 140,000 - 170,000; Full time

Benefits offered by this job

Competitive compensation

Medical, Dental, Vision benefits

Flexible vacation policy

Direct access to Leadership

Job summary

Alaffia Health in New York City is seeking an Implementation Lead to own end-to-end delivery for new Payment Integrity clients—from solution handoff through configuration, data integration, and go-live. This technical, domain-focused role requires fluency in claims data and payment integrity workflows to engage client technical and clinical stakeholders and help establish scalable implementation practices.

You will collaborate with Engineering, Product, and Claims teams to resolve issues, define

Qualifications

• 5+ years of experience in healthcare technology implementation, payment integrity, or claims auditing.
• Strong working knowledge of claims and payment integrity concepts: DRG validation, UB-04/itemized bill review, CPT/ICD-10/HCPCS, medical necessity, FWA.
• Experience configuring or implementing SaaS platforms for healthcare or health plan clients (claims platforms, payment integrity or utilization management tools, payer systems).
• Demonstrated ability to build client trust and credibility through technical expertise and reliable execution.
• Self-directed, with the ability to help define process and best practices within a growing function.
• Familiarity with payment integrity vendors such as Cotiviti, HMS/Gainwell, or Equian/Zelis is a plus.
• PMP, Lean Six Sigma, or similar project methodology experience is a plus but not required.

Responsibilities

• Own the implementation lifecycle: Manage the handoff from Solutions, scope technical requirements with the client, configure the platform, and integrate client data feeds through go-live.
• Work directly with claims data: Configure and validate payment integrity logic against claims data (UB-04/itemized bills, ICD-10, CPT/HCPCS, DRG), and troubleshoot data or configuration issues.
• Serve as the client's technical point of contact during implementation: Translate technical and clinical requirements clearly, gather specifications, and provide consistent client communication throughout the engagement.
• Coordinate cross-functionally: Partner closely with Engineering, Product, and Claims/Clinical teams to resolve issues and keep implementations on track.
• Manage the project plan and risk: Build timelines, proactively identify risks, and drive issues to resolution.
• Ensure clean handoff to Customer Success: Document implementation context and client requirements to support a smooth transition post go-live.
• Contribute to process design: Help establish the implementation methodology, templates, and standard configurations that will support Alaffia's growth.

Skills

Healthcare implementation

Payment integrity

Claims auditing

SaaS platforms

Technical liaison

Job description

Alaffia Health in New York City is seeking an Implementation Lead to own end-to-end delivery for new Payment Integrity clients—from solution handoff through configuration, data integration, and go-live. This technical, domain-focused role requires fluency in claims data and payment integrity workflows to engage client technical and clinical stakeholders and help establish scalable implementation practices.

You will collaborate with Engineering, Product, and Claims teams to resolve issues, define