Senior Manager, Payment Integrity Operations
2 weeks ago
Gainwell Technologies is seeking a seasoned leader to spearhead our Payment Integrity Client and Provider Services Operations teams. As a key member of our organization, you will be responsible for ensuring compliance and adherence with key client deliverables and contractual Service Level Agreements.
Key Responsibilities- Lead the Payment Integrity operations and call center teams, reporting to the Sr. Director of Operations, to ensure efficiency and service quality.
- Provide operational expertise for the breadth of Payment Integrity audit strategies and supporting operations.
- Analyze and evaluate business procedures to identify sources of revenue and cost reduction strategies through process improvements, new initiatives, automation, and strategic agendas/oversight.
- Implement policies and procedures that will improve day-to-day operations and maximize company productivity, performance, and service quality.
- Ensure compliance and adherence with key client deliverables and contractual Service Level Agreements.
- Develop and present reports and other written communication to the client, partnered with Account Management, to ensure client satisfaction and operational excellence.
- Eight or more years of experience in Payment Integrity Audit and Recovery with knowledge of audit strategies such as Data Mining, Clinical Medical Record Review, and Bill Audit.
- Eight or more years of experience in a senior management capacity for operations and call center, preferably in a Payment Integrity market.
- Five or more years of experience working collaboratively with multiple organizational departments, including Information Technology.
- Ability to present and communicate ideas clearly and persuasively at all levels to both internal and external audiences, including executive levels.
Gainwell Technologies is a company that values work flexibility, learning, and career development. We offer a generous, flexible vacation policy, a, and educational assistance. Our leadership and technical development academies help build your skills and capabilities.
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