Senior Manager, Payment Integrity Operations

Title: Senior Manager, Payment Integrity Operations

Location: Los Angeles, CA
Employment Type: Full Time (Hybrid)

Compensation:
Pay Range: $117,509-$152,762 Per Year

Job Summary:
• Lead and manage operations to ensure payment accuracy and financial outcomes.
• Oversee teams responsible for pre-payment reviews, audits, and recovery operations.
• Collaborate with stakeholders to implement system changes and preventive measures.
• Ensure compliance with regulatory and contractual requirements.
• Drive performance and strategic goals in alignment with the company''s mission.
• Utilize data analysis to detect risk patterns and enhance cost avoidance strategies.
• Mentor and develop staff to build technical and problem-solving skills.

Key Responsibilities:
• Manage daily operations of payment integrity activities.
• Develop and implement standardized workflows and quality review processes.
• Translate regulatory updates into actionable system changes.
• Oversee identification and recovery of overpayments and underpayments.
• Partner with stakeholders to resolve system issues and enhance accuracy.

Qualifications:
• Bachelor''s Degree or equivalent experience.
• 6+ years in payment integrity, program integrity, or related fields.
• 5+ years of leadership experience managing teams and projects.
• Experience in Medicaid, Medicare, and managed care lines of business.
• Strong analytical, financial, and operational skills.

Core Technologies:
• SQL | Business Intelligence Tools | Data Mining Platforms

Contact Authorization:
By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here  

Benefits:
Learn more about our benefits offerings here  

Onboarding Expectations:
Learn more about our Onboarding Process here  

EEO Statement:
Learn more about our EEO policy here  

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