Manager, Payment Integrity
Remote-MOremotemanager$88K – $158K
Posted today · via Workday
About this role
Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes Monitor business processes and systems to assure integrity and compliance in billing and claims payment Lead teams of analysts to appropriately investigate all possible fraud, waste and abuse referrals Develop customized fraud plans to meet contract and federal requirements Develop educational materials to identify/validate waste activities as requested by the health plan and on an ad-hoc basis Respond to RFP request and implement new policies per contractual obligation Attend state/federal meetings as required by specific contracts Prepare/present the FWA program to state/federal personnel upon request, specifically during…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
For this role: go, teams
2
Level fit
This role is manager-level. We check your trajectory against it.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible. We factor in your stated location and time-zone overlap.
Score yourself on this role.
Free · no card · written explanation included
Skills in this role
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