Senior Manager, Payment Integrity – Intake Demand

This is a fully remote position, open to applicants in Florida, +2 more states.

📋 Description

• Supervise and evaluate both internal and external initiatives for cost recovery and cost containment in relation to project metrics and anticipated recovery and cost avoidance objectives for each Health Plan.

• Manage cost avoidance and cost recovery initiatives involving both internal and external vendors.

• Collaborate with health plans and national vendors to identify and manage costs across various recovery categories.

• Create annual budgets and projected goals for each national vendor, assisting in the achievement of anticipated annual savings.

• Assess and optimize current processes while establishing new cost-reduction strategies.

• Present data on trends and opportunities for cost containment, propose action plans, and support their implementation.

• Assist health plans in navigating cost recovery regulations, rules, and processes.

• Oversee the performance and processes of other departments, evaluating them for cost recovery effectiveness.

• Compile and deliver reporting packages to Senior Management regarding cost avoidance and cost recovery initiatives.

⛳️ Requirements

• A Bachelor’s degree in Accounting, Finance, Healthcare Management, a related field, or equivalent experience.

• Over 6 years of experience in data analysis, finance, or accounting.

• Preferred experience in auditing government programs and compliance monitoring programs.

• Project management experience is preferred.

• Experience in intake demand management is preferred.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement programs.

• Paid time off in addition to holidays.

• A flexible work approach, accommodating remote, hybrid, field, or office schedules.

• Additional incentive forms may be included in the total compensation package.