Third Party Liability (TPL) Lead
New
J
JobgetherHealthcare Medicaid
USFull-TimeLead
Salary90,000 - 120,000 USD per year
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Job Details
- Experience
- Minimum of three years of experience within the last five years
- Required Skills
- Project ManagementData AnalysisCompliance
Requirements
- Minimum of three years of experience within the last five years in a comparable Medicaid, healthcare, TPL, program integrity, operations, leadership, or consulting role.
- Experience leading or supporting Medicaid Third Party Liability, recovery, cost avoidance, audit, compliance, policy, or related operational activities.
- Strong understanding of Medicaid coordination of benefits, third-party payer data, recovery processes, lien-related activities, and payer-of-last-resort principles.
- Experience interpreting and applying federal and state Medicaid requirements.
- Ability to coordinate projects across multiple functions including legal, finance, analytics, claims, eligibility, policy, and audit.
- Strong project leadership, facilitation, communication, analytical, and stakeholder management skills.
- Ability to analyze claims data, eligibility information, and operational performance metrics.
- Experience supporting business process redesign within Medicaid, healthcare, claims, or program integrity environments.
- Experience managing or coordinating the work of subject matter experts, analysts, or project team members.
- Familiarity with Medicaid eligibility systems, claims platforms, or vendor-managed healthcare data environments.
- Ability to travel up to 25% of the year as required.
Responsibilities
- Lead Third Party Liability operations including cost avoidance, recovery activities, lien-related processes, vendor coordination, and quality assurance.
- Oversee subject matter experts by reviewing analyses, recommendations, and documentation.
- Collaborate with program integrity and policy teams to align TPL initiatives with compliance, audit, and system priorities.
- Provide guidance to stakeholders on Medicaid TPL requirements and operational best practices.
- Lead the development, tracking, and improvement of TPL lien-related processes.
- Facilitate meetings, manage action items, monitor decisions, and support issue resolution.
- Analyze existing workflows and lead business process redesign efforts to improve efficiency and recovery outcomes.
- Collaborate across technology, process improvement, and change management teams.
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