Senior Payment Integrity Programs Leader

Devoted Health; United States; Hybrid; USD 111,000 - 150,000; Full time

Benefits offered by this job

Health insurance

Dental plan

Vision plan

Paid time off

Mobile/internet stipend

Stock options

Bonus eligibility

401K

Job summary

Devoted Health is seeking a senior leader to oversee its Payment Integrity Program Development. You will drive complex, multi‑phase initiatives, partner with clinical, coding, and engineering teams, and optimize program performance across internal and vendor networks.

You will lead investigations of complex claims, develop actionable recommendations, and contribute to scalable, compliant processes that improve savings realization and provider experience.

Qualifications

• Bachelor’s degree and 6+ years in health plan, payment integrity, or related setting.
• Strong expertise in healthcare claims, payment integrity, or related operations.
• Experience implementing, validating, maintaining, or optimizing payment integrity edits or audits.
• Ability to independently investigate complex claims and perform root cause analysis.
• Strong analytical literacy and ability to interpret metrics and trends.
• Experience leading complex, multi‑phase initiatives with limited oversight.
• Strong communication, prioritization, and influencing skills across functions.

Responsibilities

• Manage internal and vendor-supported payment integrity programs across implementation and maintenance.
• Evaluate performance: savings, hit rates, yield, turnaround times, provider impact.
• Investigate complex claims and derive evidence-based recommendations.
• Translate concepts with clinical and coding SMEs into implementation requirements.
• Coordinate maintenance, monitoring, regulatory updates, and compliance activities.
• Identify inefficiencies and drive cross-functional improvements using automation and tech.

Skills

Analytical literacy

Communication

Leadership

Root cause analysis

Cross-functional collaboration

Independent judgment

Project management

Education

Bachelor’s degree

Tools

SQL

AI analytics tools

Automation

Job description

Devoted Health is seeking a senior leader to oversee its Payment Integrity Program Development. You will drive complex, multi‑phase initiatives, partner with clinical, coding, and engineering teams, and optimize program performance across internal and vendor networks.

You will lead investigations of complex claims, develop actionable recommendations, and contribute to scalable, compliant processes that improve savings realization and provider experience.