Program Manager III – Recovery Operations, Payment Integrity

This is a fully remote position, open to applicants in Florida, +6 more states.

📋 Description

• Oversee the management of recoupment claim inventory and monitor BOT automation.

• Ensure that Payment Integrity processes in Amisys, Facets, Xcelys, and ABS function as intended.

• Address inventory and BOT automation challenges promptly.

• Analyze savings BOT automation issues to pinpoint and resolve potential problems.

• Collaborate with subject matter experts in recoupment programs, IT, and Claims teams.

• Discover opportunities to enhance efficiency, elevate service levels, and maintain regulatory compliance.

• Formulate strategies to capitalize on improvement opportunities and align organizational goals and resources.

• Manage various projects throughout the entire project life cycle, including gathering requirements, creating project plans and schedules, managing resources and budgets, executing, deploying, and closing projects.

• Utilize corporate and industry-standard project management tools and methodologies.

• Keep project documentation, action items, issue lists, and risk mitigation strategies up to date.

• Lead and convey project updates to stakeholders through executive summaries and presentations.

• Negotiate with stakeholders to secure necessary resources, address issues, and reduce risks.

• Facilitate cross-functional meetings.

• Provide both functional and technical expertise concerning program requirements and operations.

⛳️ Requirements

• Bachelor’s degree in Business Administration, Healthcare Administration, a related field, or equivalent experience.

• A minimum of 5 years of experience in project implementation, product, or program management.

• Preferred experience in managed care or prescription benefit management.

• Experience in leading initiatives within healthcare recovery operations, payment integrity, claims operations, revenue cycle, or similar healthcare business functions is preferred.

• A Master’s degree is preferred.

🏝️ Benefits

• Health insurance.

• 401K plan.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Competitive compensation.

• Potential for additional incentive opportunities.