Payment Integrity Program Lead (Healthcare Operations)

PacificSource; Boise, Northern (ID, KY); Hybrid; USD 57,000 - 97,000; Full time

Job summary

PacificSource is seeking a Payment Integrity Program Specialist in Boise, ID to coordinate vendor activities, support new integrity initiatives, and monitor savings and performance metrics. The role interfaces with Claims, Finance, Compliance, and IT to ensure successful program execution.

The role requires healthcare operations experience, project coordination skills, and proficiency in Excel/PowerPoint. Travel is limited.

Qualifications

• Experience in healthcare operations, project coordination, or vendor management.
• Knowledge of claims administration and payment integrity concepts is preferred.
• Proficiency in generating reports, analyzing data, and managing documentation.

Responsibilities

• Coordinate day-to-day activities with external payment integrity vendors and business partners.
• Support implementation of new payment integrity initiatives, audits, and recovery projects.
• Track vendor performance, SLAs, recoveries, and project milestones.
• Prepare reports and supporting documentation for leadership and committees.
• Assist with regulatory reporting and documentation requirements.
• Maintain program documentation and workflows.

Skills

Microsoft Excel

PowerPoint

Business productivity tools

Education

Bachelor's degree

Job description

PacificSource is seeking a Payment Integrity Program Specialist in Boise, ID to coordinate vendor activities, support new integrity initiatives, and monitor savings and performance metrics. The role interfaces with Claims, Finance, Compliance, and IT to ensure successful program execution.

The role requires healthcare operations experience, project coordination skills, and proficiency in Excel/PowerPoint. Travel is limited.