Director, Payment Integrity Client and Provider Services Operations

2 weeks ago


Texas, United States Gainwell Technologies Full time
Job Summary

Gainwell Technologies is seeking a seasoned leader to oversee the Payment Integrity Client and Provider Services Operations teams. As a key member of our leadership team, 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 to ensure efficiency and service quality.
  • Provide operational expertise for the breadth of Payment Integrity audit strategies and supporting operations.
  • Oversee Payment Integrity revenue forecast analysis and operational team performance to ensure revenue forecast projections are met or exceeded.
  • Monitor performance metrics, including client satisfaction, response times, and resolution rates, to ensure targets are met.
  • Review, analyze, and evaluate business procedures to identify sources of revenue and cost reduction strategies through process improvements, new initiatives, automation, and strategic agendas.
  • 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.
  • Identify, perform root cause analysis, and develop immediate action plans impacting operational performance.
  • Set the vision and direction for the call center to drive performance and ensure a high level of customer satisfaction.
  • Develop and present reports and other written communication to the client, partnered with Account Management, to ensure client satisfaction and operational excellence.
  • Interact with executives and supporting staff.
  • Support collaboration and communicate broadly to ensure overall coordination of goals and objectives between internal teams such as Account Management, IT, Implementation, Sales, Product, and other key internal stakeholders.
  • Oversee hiring, training, development, and performance management.
Requirements
  • 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.
  • Strong leadership, project management, and process optimization skills.
What We Offer

This role is 100% remote, based in the U.S. Gainwell Technologies offers a competitive salary range of $137,100.00 - $145,000.00 per year, depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. We also offer a generous, flexible vacation policy, a 401(k) match, and educational assistance. Our leadership and technical development academies will help you build your skills and capabilities.



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