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Senior Manager, Payment Integrity Services

2 months ago

Texas, United States Gainwell Technologies Full time

About This Role

Gainwell Technologies is seeking a seasoned leader to oversee the Payment Integrity Client and Provider Services Operations teams. As the Director, Payment Integrity Operations Leader, 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.
  • 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.
  • 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.
  • Strong leadership, project management, and process optimization skills.

About Gainwell Technologies

Gainwell Technologies is a company that values work flexibility, learning, and career development. We offer a generous, flexible vacation policy, a, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.