Senior Director Payment Integrity Operations
Job Description
Team: Others
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Director Payment Integrity Operations in United States.
This leadership role offers the opportunity to drive operational excellence within a fast-paced healthcare technology environment focused on payment integrity and business transformation. The position oversees large-scale operational functions, client delivery, and process optimization initiatives that directly impact organizational growth and service quality. You will collaborate cross-functionally with senior stakeholders, lead high-performing teams, and shape scalable operational strategies across complex healthcare workflows. The role combines strategic planning with hands-on execution, requiring strong expertise in operational leadership, client engagement, and performance improvement. This is an ideal opportunity for a results-driven leader who thrives in dynamic environments and enjoys building efficient, client-centric operations. With broad visibility across the organization, this position plays a key role in driving innovation, operational scalability, and long-term business success.
Accountabilities:
- Lead and oversee business operations for payment integrity programs, ensuring scalable, high-quality service delivery aligned with operational and client objectives.
- Support client engagements, RFP/RFI responses, and intake processes by developing tailored operational solutions and cost strategies.
- Drive operational transformation initiatives focused on process improvement, workforce optimization, service quality, and productivity enhancement.
- Partner closely with cross-functional leaders to strengthen operational excellence, improve service outcomes, and support business growth initiatives.
- Develop KPIs, reporting structures, and performance benchmarks to monitor operational effectiveness and continuous improvement efforts.
- Ensure compliance with regulatory, accreditation, client, and internal governance requirements across all operational activities.
- Lead, mentor, and develop high-performing teams while fostering a collaborative, accountable, and customer-focused culture.
- Manage operational planning, risk mitigation, scheduling, and escalation management to ensure service levels and client expectations are consistently exceeded.
- Present operational updates, improvement strategies, and performance insights to executive leadership and external stakeholders.
- Support strategic initiatives, business expansion efforts, and organizational alignment within a matrixed and evolving environment.
- Bachelor’s degree in business, healthcare, operations, or a related field required; Master’s degree preferred.
- 10+ years of leadership experience in operations management, healthcare administration, consulting, or related environments.
- Strong expertise in healthcare payment operations, adjudication workflows, payment integrity, or health plan operations preferred.
- Experience leading operational transformation, implementations, transitions, or process optimization initiatives.
- Demonstrated success managing operational budgets, workforce planning, and performance improvement strategies.
- Proven leadership capabilities with experience hiring, mentoring, and developing high-performing teams.
- Excellent analytical, organizational, problem-solving, and decision-making skills.
- Strong communication and executive presentation abilities with experience interacting directly with clients and senior leadership.
- Familiarity with Lean Six Sigma, PMP, CPP, or similar operational excellence methodologies is highly valued.
- Advanced understanding of operational metrics, technology-enabled process improvements, and software implementation initiatives.
- Ability to thrive in fast-paced, matrixed environments while managing multiple priorities and stakeholder relationships effectively.
- Willingness to travel as needed and collaborate across global or distributed teams.
- Competitive base salary ranging from $160,000 to $190,000 annually, based on experience and qualifications.
- Eligibility for discretionary bonus programs.
- Comprehensive medical, dental, and vision insurance coverage.
- Life insurance and disability benefits.
- 401(k) retirement savings plan.
- Paid family leave and generous paid time off package.
- 9 paid holidays annually.
- Fully remote work flexibility within the United States.
- Opportunity to lead high-impact operational initiatives in a growing healthcare technology environment.
- Collaborative culture focused on innovation, leadership development, and operational excellence.
Requirements:
Benefits:
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Date Posted
05/11/2026
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