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Payment Integrity Operations Manager - Detroit Michigan

Company: VirtualVocations
Location: Detroit, Michigan
Posted On: 01/30/2025

A company is looking for a Payment Integrity Operations Manager responsible for overseeing provider audit programs and ensuring compliance and performance monitoring.



Key Responsibilities:

Develop and execute Payment Integrity strategy in collaboration with leadership
Monitor external vendor performance and produce provider scorecards for Payment Integrity initiatives
Ensure compliance with regulatory standards and oversee the production of regulatory and KPI reports


Qualifications:

Bachelor's degree required; Master's degree in Business Administration or related field preferred
5+ years of healthcare/managed care experience required
5+ years of claims Payment Integrity experience required
CPC or CCS certification preferred
Project management experience and certification preferred More...

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