DevotedHiring

Payment Integrity Program Development Senior Manager

  • Remote, United States
  • Lead
  • Posted 5 days ago
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In one line

Senior role managing a portfolio of payment integrity edits and audits, both internal and vendor-run, so provider claims get paid correctly. High autonomy, outcomes driven.

About the role

The team works on the problem of claims paid wrongly or late, and this role turns concept logic into working programs. Good work means better savings, faster turnaround and fewer provider problems.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, United States
Seniority
Lead
Skills
Claims, Reimbursement, Root Cause Analysis, Data Science, Compliance
Posted
30 Oct 2026
Last checked
3 Nov 2026

What you will do

  • Run assigned payment integrity programs through implementation, monitoring, maintenance and support
  • Check performance on savings, hit rates, yield and turnaround, and flag risks or fixes
  • Investigate complex claims and configuration issues, find root causes and drive resolution
  • Turn concept logic into implementation requirements with clinical, coding and engineering partners
  • Coordinate maintenance, backsweeps, regulatory updates and compliance activities

What they look for

  • Claims and reimbursement expertise plus analytical judgment
  • Experience leading complex, multi-phase work across functions
  • Comfort challenging assumptions and building a clear point of view
  • Skill with claims data, operational metrics and analytical tools
  • Ability to manage vendor-supported programs and hold them to outcomes

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Questions about this job

Is this a remote job, and where can I work from?

The posting lists it as remote for people in the United States.

What does this job pay?

No pay range is stated in the posting.

What experience is needed?

It is a lead role. The posting asks for: claims and reimbursement expertise plus analytical judgment; experience leading complex, multi-phase work across functions; comfort challenging assumptions and building a clear point of view. Skills it names include Claims, Reimbursement, Root Cause Analysis, Data Science.

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