Senior Payment Integrity Strategy Lead — Stock Options

Devoted; United States; A distancia; USD 111.000 - 150.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, Dental & Vision plan

Generous paid time off

Stock options

401K program

Parental leave

Descripción de la vacante

Devoted Health seeks a Payment Integrity Program Development Senior Manager to lead complex, multi-phase initiatives across implementation, validation, and performance monitoring. You will manage internal and vendor-supported payment integrity programs, driving improvements in savings, turnaround times, and provider experience.

You will partner with clinical, coding, and reimbursement SMEs and collaborate with Engineering, Product, Data Science, and operations teams to translate concepts into

Formación

• Bachelor's degree and at least 6 years in health plan, payment integrity, or related setting.
• Strong expertise in healthcare claims, payment integrity, or reimbursement operations.
• Experience implementing, validating, maintaining, or optimizing payment integrity edits and audits.
• Ability to investigate complex claims, perform root cause analysis, and translate findings into solutions.
• Strong analytical literacy with claims data, metrics, and performance trends.
• Ability to lead multi-phase initiatives across functions with limited oversight.

Responsabilidades

• Manage internal and vendor-supported payment integrity programs across implementation, monitoring, maintenance, and ongoing support.
• Evaluate program performance, including savings, hit rates, yield, and turnaround times.
• Independently investigate complex claims and determine root causes; drive resolution.
• Translate concept logic into implementation requirements with clinical, coding, and reimbursement SMEs.
• Coordinate portfolio maintenance, monitoring, and regulatory updates.
• Identify inefficiencies and drive workflow, automation, and process improvements.
• Use data and metrics to inform recommendations and decisions.
• Lead cross-functional collaboration across departments to achieve outcomes.

Conocimientos

Claims editing

Payment integrity

Healthcare claims

Data analysis

Root cause analysis

Project leadership

Cross-functional leadership

Communication

Educación

Bachelor's degree

Herramientas

SQL

Automation tools

AI analytics

Descripción del empleo

Devoted Health seeks a Payment Integrity Program Development Senior Manager to lead complex, multi-phase initiatives across implementation, validation, and performance monitoring. You will manage internal and vendor-supported payment integrity programs, driving improvements in savings, turnaround times, and provider experience.

You will partner with clinical, coding, and reimbursement SMEs and collaborate with Engineering, Product, Data Science, and operations teams to translate concepts into