Senior Manager, Payment Integrity – Vended Audit Programs

This is a fully remote position, open to applicants in Illinois, +3 more states.

📋 Description

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

• Oversee vendors' initiatives for cost avoidance and recovery.

• Collaborate with health plans to pinpoint and control costs via national vendors for every recovery category.

• Create annual budgets and forecasted targets for national vendors while assisting them in reaching their projected annual savings.

• Assess and enhance current processes and introduce new cost-reduction strategies.

• Present trends and opportunities for cost containment, suggest action plans, and support implementation efforts.

• Assist health plans in understanding the rules, regulations, and processes related to cost recovery.

• Monitor the performance and processes of other departments and assess them for cost recovery opportunities.

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

• Perform additional duties as required.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor’s degree in Accounting, Finance, Healthcare Management, or 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.

• Project management experience is a plus.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

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

• Additional incentive options may be included in overall compensation.