Senior Director Payment Integrity Operations

New

United StatesFull-TimeDirector

Salary160,000 - 190,000 USD per year

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Job Details

Bachelor’s degree in business, healthcare, operations, or a related field required; Master’s degree preferred.
10+ years of leadership experience in operations management, healthcare administration, consulting, or related environments.
Expertise in healthcare payment operations, adjudication workflows, payment integrity, or health plan operations.
Experience leading operational transformation, implementations, transitions, or process optimization.
Demonstrated success managing operational budgets, workforce planning, and performance improvement strategies.
Proven leadership capabilities with experience hiring, mentoring, and developing teams.
Excellent analytical, organizational, problem-solving, and decision-making skills.
Strong communication and executive presentation abilities.
Familiarity with Lean Six Sigma, PMP, CPP, or similar operational excellence methodologies.
Advanced understanding of operational metrics and technology-enabled process improvements.

Lead and oversee business operations for payment integrity programs.
Support client engagements, RFP/RFI responses, and intake processes.
Drive operational transformation initiatives focused on process improvement.
Partner closely with cross-functional leaders to strengthen operational excellence.
Develop KPIs, reporting structures, and performance benchmarks.
Ensure compliance with regulatory and internal governance requirements.
Lead, mentor, and develop high-performing teams.
Manage operational planning, risk mitigation, and escalation management.
Present operational updates and performance insights to executive leadership.
Support strategic initiatives and organizational alignment.

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