Strategic Lead, Payment Integrity Policy & Implementation

Cambia Health Solutions; Burlington (WA); Hybrid; USD 122,000 - 165,000; Full time

Benefits offered by this job

Medical,dental, vision coverage

Health savings account

Paid time off

401(k) with company match

Parental leave

Wellness programs

Commuting benefits

Job summary

Cambia Health Solutions is hiring for a hybrid role across multiple offices, including Salt Lake City and nearby locations, to lead reimbursement policy and payment integrity initiatives. You will supervise a team and collaborate with legal, compliance, and healthcare informatics to drive strategic programs.

The role emphasizes policy development, coding reviews, and health economics, with a focus on improving affordability and patient care while leading change across the enterprise.

Qualifications

• Masters (or higher) degree in a health-related field required.
• Seven years of management or professional experience in a health care setting.

Responsibilities

• Lead strategy and execution of reimbursement policy and payment integrity initiatives.
• Oversee budgeting, policies, workflows and change management across teams.
• Direct Reimbursement Policy Committee with cross-enterprise stakeholders.
• Drive innovation in affordability initiatives and coding dispute resolution.
• Provide long-term roadmaps for reimbursement policy and related strategy.

Skills

Policy development

Coding reviews

Operational strategy

Health economics

Stakeholder management

Communication skills

AI tools

Education

Masters degree in health-related field

Master's in public health / related field desired

Tools

AI tools

Job description

Cambia Health Solutions is hiring for a hybrid role across multiple offices, including Salt Lake City and nearby locations, to lead reimbursement policy and payment integrity initiatives. You will supervise a team and collaborate with legal, compliance, and healthcare informatics to drive strategic programs.

The role emphasizes policy development, coding reviews, and health economics, with a focus on improving affordability and patient care while leading change across the enterprise.