Strategic Leader, Payment Integrity Enablement & Training

Inland Empire Health Plans; Rancho Cucamonga (CA); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Competitive salary

State of the art fitness center on‑sit

Medical Insurance with Dental and VIs}

Job summary

Inland Empire Health Plans (IEHP) invites you to join our Payment Integrity Enablement team as Manager, leading education, provider guidance, and compliance initiatives to reduce errors and promote billing accuracy.

Reporting to the Director of Payment Integrity, you will oversee curriculum design, governance, and training delivery, collaborate with Claims, Compliance, and SIU/FWA, and drive measurable financial and operational improvements aligned with IEHP's quality goals.

Qualifications

• Seven years of experience in healthcare payment integrity, revenue cycle, and/or FWA prevention.
• Leadership experience mentoring, coaching, or training team members.
• Experience with IEHP lines of business (Medi-Cal, Medicare, Commercial) preferred.
• Bachelor’s degree in healthcare administration or related field required; master’s preferred.
• Certification such as CPC, CHA, CCS, PMP or related required.

Responsibilities

• Provide strategic and operational leadership over education and training for payment integrity.
• Oversee end-to-end design, governance, and execution of training programs.
• Collaborate cross-functionally with Claims, Provider Relations, Compliance, and SIU/FWA.
• Lead curriculum development, standardize operations, and drive performance improvements.
• Identify risk areas and promote coding accuracy to improve billing integrity.

Skills

Leadership

Training & mentoring

Communication & presentation

Data analysis

Project management

Regulatory compliance

Cross-functional collaboration

SQL

BI tools

Data mining platforms

Education

Bachelor’s degree in healthcare administration

Master’s degree in healthcare administration

Certification: CPC/CHA/CCS/PMP

Tools

Microsoft Office

SQL

BI tools

Data mining platforms

Job description

Inland Empire Health Plans (IEHP) invites you to join our Payment Integrity Enablement team as Manager, leading education, provider guidance, and compliance initiatives to reduce errors and promote billing accuracy.

Reporting to the Director of Payment Integrity, you will oversee curriculum design, governance, and training delivery, collaborate with Claims, Compliance, and SIU/FWA, and drive measurable financial and operational improvements aligned with IEHP's quality goals.