Risk Management Lead

Ladders

United States

Remote

USD 104,000 - 143,000

Full time

5 days ago
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Benefits offered by this job

Medical, dental, and vision benefits
401(k) retirement savings plan
Paid time off and holidays
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance and wellness

Job summary

Ladders is seeking a Risk Management Lead to join our healthcare operations team. You will lead investigations into claim payment errors, manage audit responses, and drive corrective action planning.

You will partner with internal and external stakeholders to strengthen controls, translate contract requirements into operational practices, and mentor staff while guiding implementation workplans for key initiatives.

Qualifications

  • 5+ years of experience in healthcare claims operations, audit, or compliance.
  • Strong knowledge of reimbursement methodologies for Institutional and Professional claims.
  • 2+ years of experience leading projects or teams.
  • Experience resolving claim payment errors and audit findings.
  • Proficiency in Microsoft Office, especially Excel, Word, and PowerPoint.

Responsibilities

  • Lead investigations into alleged claim payment errors for audits.
  • Train and mentor staff on audit preparation and documentation.
  • Document root causes of errors and support corrective action planning.
  • Collaborate with internal and external partners on audit findings.
  • Provide expertise on high-dollar claims and their resolution.
  • Translate contract requirements into operational processes and controls.
  • Develop implementation workplans for projects and initiatives.

Skills

Healthcare claims operations
Audit/compliance
Team leadership
Root cause analysis
Mentoring/training
Excel/Office

Tools

Microsoft Excel
Microsoft Word
PowerPoint

Job description

For our client, we are seeking a Risk Management Lead to join the team of a leader in the Healthcare space.

This role will lead claim payment error investigations, audit response activities, and corrective action planning across healthcare operations. You will partner with internal and external stakeholders to strengthen controls, translate contract requirements into operational practices, and support the resolution of high-dollar claims. The position also involves mentoring team members and helping drive implementation workplans for key initiatives.

Location: Remote - US based candidates only, no visa sponsorship available

Compensation: $104,000-$143,000 annually

Responsibilities
  • Lead investigations into alleged claim payment errors for audits
  • Train and mentor staff on audit preparation and documentation
  • Document root causes of errors and support corrective action planning
  • Collaborate with internal and external partners on audit findings
  • Provide expertise on high-dollar claims and their resolution
  • Translate contract requirements into operational processes and controls
  • Develop implementation workplans for projects and initiatives
Qualifications
  • 5+ years of experience in healthcare claims operations, audit, or compliance
  • Strong knowledge of reimbursement methodologies for Institutional and Professional claims
  • 2+ years of experience leading projects or teams
  • Experience resolving claim payment errors and audit findings
  • Proficiency in Microsoft Office, especially Excel, Word, and PowerPoint
Benefits
  • Medical, dental, and vision benefits
  • 401(k) retirement savings plan
  • Paid time off and holidays
  • Paid parental and caregiver leave
  • Short-term and long-term disability insurance
  • Life insurance and additional wellness opportunities

Our client is an equal opportunity employer. We encourage you to apply even if you don't meet every qualification - your background could be exactly what this team needs.

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