Director - Payment Integrity

Point32health Inc

Canton, MA, United States
Base: $160,335.20 - $240,502.80; bonus/equity: not...
On-site
Develop and execute payment integrity strategies
Manage internal teams and external vendors
Oversee payment policy and edit configuration
Point32Health is seeking a Director of Payment Integrity to oversee strategies for optimizing payment accuracy and enhancing audit capabilities within their healthcare organization. The ideal candidate will have substantial leadership experience in payment integrity functions and a strong understanding of healthcare regulations

Job Summary

  • Lead the development and execution of strategies to optimize payment accuracy and expand the organization's audit capabilities.
  • Responsible for daily oversight of key functions including Payment Policy, Edit configuration and maintenance, management of multiple internal teams and external vendor audit functions.
  • Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes: Medical, dental and vision coverage, Retirement plans, Paid time off.

Matching Summary

Match Score: 85

Point32Health is seeking a Director of Payment Integrity to oversee strategies for optimizing payment accuracy and enhancing audit capabilities within their healthcare organization. The ideal candidate will have substantial leadership experience in payment integrity functions and a strong understanding of healthcare regulations.

Salary

Base: $160,335.20 - $240,502.80; Bonus/Equity: Not specified; Benefits: Medical, dental, vision, retirement, PTO, life/disability insurance, tuition program, well-being benefits

Skills & Requirements

Must-have

  • Develop and execute payment integrity strategies
  • Manage internal teams and external vendors
  • Oversee payment policy and edit configuration
  • Monitor performance metrics and KPIs
  • Ensure regulatory compliance

Nice-to-have

  • Collaborate with internal departments
  • Enhance operational efficiencies
  • Provide service with empathy

Key Requirements

  • 5 years leadership/management experience in Payment Integrity/Audit
  • Experience managing external audit vendors
  • Operational experience with pricing software
  • Bachelor's degree in Healthcare Administration or Business Administration

Work Rights

Not specified

Tailored Resume

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