Oversee and monitor the performance of both internal and external cost recovery and cost containment initiatives according to targeted project metrics and forecasted recovery and cost avoidance goals for each Health Plan
Manage internal and external vendors cost avoidance and cost recovery initiatives
Partner with health plans to identify and contain cost through collaboration with national vendors for each recovery category
Develop annual budget and projected target for each national vendor and assist them with achieving projected annual savings
Evaluate and streamline existing processes and implement new processes to reduce costs
Present trends and cost containment opportunities, recommend action plans, and assist with the implementation of those plans
Assist health plans in understanding the rules, regulations and processes around cost recovery
Monitor other departments’ performance and processes and evaluate for cost recovery
Compile and Present reporting packages for Senior Management on current cost avoidance and cost recovery initiatives

Bachelor’s degree in Accounting, Finance, Healthcare Management, related field or equivalent experience
6+ years of data analysis, finance or accounting experience
Experience with government programs auditing, and compliance monitoring programs preferred
Project management experience preferred

Senior Manager, Payment Integrity Governance

Key skills