Remote Health Plan Payment Integrity Lead
Molina Healthcare, Inc.
- Remote job
Molina Healthcare of Kentucky is seeking a Program Manager, Health Plan Payment Integrity (Claims & Recovery) to lead PI efforts remotely. You will oversee SAIs, ensure regulatory compliance, and collaborate with CMS/state teams to optimize pre-pay edits, post-payment datamining, and overpayment recovery. The role emphasizes independent ownership, strong analytical skills, and effective communication across cross-functional teams to improve cost containment and provider outcomes. #J-18808-Ljbffr Molina Healthcare, Inc.
$94.9k - $130.5k
...our caring community The Payment Integrity Lead uses technology and data mining... ...WORK STYLE: Remote, work at home. While this is... ...eligible for a bonus incentive plan. This incentive opportunity... ...serve to achieve their best health – delivering the care and service...Remote workBi-weekly payFull timeTemporary workWork at officeWork from homeHome officeMonday to Friday- ...seasoned coder to join our claims and payment integrity team. You will collaborate with external... ...HCPCS knowledge and at least five years in health insurance or managed care.... ...CPC and AHIMA are required. This is a remote position with a 40-hour work week. #J-...Remote jobHealth Insurance
- Jobgether is seeking a Program Manager, Health Plan Payment Integrity (Claims & Recovery) in the United States. This remote, full-time role leads payment integrity initiatives, oversees recovery programs, and works with claims, finance, compliance, and network teams to...Remote jobHealth InsuranceFull time
- ...Integrated Solutions Team Lead Kurv is currently seeking a POS/Software Systems Technician... ...interfaces. Provide remote installation and training... ...Services, Electronic Payments Industry or with a leading... ...k) ~ Dental insurance ~ Health insurance ~ Health savings...Remote workHealth InsuranceFull timeWork experience placementCasual workWork at officeShift work
$59.81k - $129.59k
...Healthcare of Kentucky is hiring a Program Manager, Health Plan Payment Integrity (Claims & Recovery). This position is remote. Highly Qualified Candidates Will Have the... ...integrity (PI) solutions. • Independently leads efforts to improve claim payment accuracy, claim...Remote workHealth InsuranceFull timeTemporary workWork at office- ...rapidly growing venture-backed SaaS provider of payments and financial solutions for the MSP industry.... ...Customer Success, run the onboarding pipeline, lead weekly reviews, and build self‑serve guides to scale. This remote, full-time role focuses on delivering smooth payments...Remote jobFull timeContract workLive in
$21.5 - $39.75 per hour
Job Description Summary Lead POS & Payment Systems Technician to oversee our... .... Payment Processing & Integration Oversight Lead the setup and... ...Android‑based POS systems and remote management tools. Bilingual... ...Insurance Coverage 401(k) Savings Plan Paid Time Off (PTO) based on...Remote workHealth InsuranceHourly payWork experience placementSummer workH1bVisa sponsorshipRelocation package$69.45k - $135.42k
...partner is looking for a Program Manager, Health Plan Payment Integrity (Claims & Recovery) based in the... ...experienced healthcare professional to lead payment integrity initiatives that improve... ...results. This is a full-time remote position in a highly regulated, cross-...Remote workHealth InsuranceFull timeTemporary workWork at office$110.5k - $150k
...role: The Senior Manager of Payment Integrity is responsible for data-... ...delivery team, driving daily queue health, turnaround times, quality... ...operational accuracy. #LI-DS1 #LI-Remote Salary range: $110,500 -... ...health, dental and vision plan with low or no premium ~...Remote workHealth InsuranceFull timeContract workInternship$87.7k - $157.8k
...monitoring trends/schemes Lead Outstanding Claims... .../Network Operations, Health Plans, IT, and vendors to resolve... ...and systems to assure integrity and compliance in billing and claims payment. Develop customized... ...approach to work with remote, hybrid, field or office...Remote workHealth InsuranceFull timeContract workPart timeWork at officeImmediate startFlexible hours- ...Payment Integrity Drg Coding & Clinical Validation Analyst... ...Code of Conduct, and leading to the Lifetime Way values... ...bachelor's degree in health information management... ...travel across the Health Plan service region for... ...: The opportunity for remote work may be possible for...Remote workHealth InsuranceWork experience placement
$73k - $125k
...conducting prepayment and post-payment clinical reviews of... ..., and Payment Integrity guidelines. This role... ...complications of care, discharge planning, and transitions of... ...meet deadlines in a remote work environment.... ...readmission reviews for a health plan, hospital,...Remote workHealth InsuranceFull timeContract workInternship- ...Role: Senior Integrated Tool Chain Lead for SAP S/4HANA Transformation Location: Remote with Travel Hire Type: Full Time 12 - 1... ...environments, including ARTs, PI planning, cross-ART dependencies,... ...dashboards and KPIs covering delivery health, backlog status, testing...Remote workHealth InsuranceFull time
$150k - $200k
...Opportunity: Global Tax Lead Tilt is hiring... ...on cross-border payments, treaty... ...risk, including for remote employees and contractors... ...Look for planning opportunities that... ...markets; experience integrating acquired foreign companies... ...: Find flexible health plans at every...Remote workHealth InsurancePermanent employmentFull timeFor contractorsWork at officeLocal areaWork from homeWorldwideFlexible hours$160k - $200k
...Defense customers by developing innovative remote sensing algorithms, tools, and... ...be considered. SciTec is seeking an Integration Lead who is responsible for leading the technical... ...Disability insurance ~ Annual Profit-Sharing Plan ~ Discretionary Performance Bonus ~...Remote workHealth InsuranceTemporary workFor contractorsWork experience placementFlexible hours$132.4k - $251.6k
...Location: US-NY-REMOTE Position Role... ...our three market leading businesses, world-... ...currently seeking a Lead Integrated Program Scheduler... ...of process plans and schedules for... ...benefits Ovia Health, fertility, and family... ...bargaining agreement. Payments under these annual...Remote workHealth InsuranceFull timeContract workTemporary workWork experience placementFor subcontractorWork at officeWork from homeFlexible hours- TBoxCloud is seeking a Sr. Business Analyst for Enterprise Integrations. In this role, you will lead integration projects, collaborating with teams for... ...position is contract-based and offers competitive rates, health insurance, 401(k), stock options, and vacation time....Remote jobHealth InsuranceContract work
$132.4k - $251.6k
...With our three market leading businesses, world-class... ...(RDPL) Lead Software Integration Solutions Architect in... ...status to leadership.Plan, update, and execute regression... ...as on-site, hybrid or remote.The salary range for... ...bargaining agreement. Payments under these annual...Remote workHealth InsuranceTemporary workWork experience placementWork at officeLocal areaRelocationFlexible hours$125.24k - $187.86k
...Remote - US Full time Lyric is the trusted leader... ...AI with clinical, payment, regulatory, and policy... ...decision-making so health plans can make faster, more... ...Strategic Client Programs Lead serves as the central... ...Develop and maintain an integrated program plan covering...Remote workHealth InsuranceFull timeVisa sponsorship- ...steps. Our partner is looking for a Lead Solutions Architect — ServiceNow & API Integration (Secret) based in the United... ...operational readiness. The role is fully remote within the United States and... ...opportunities. 401(k) plan with a 100% company match on contributions...Remote workHealth InsuranceWeekly payFull timeWork at officeHome office
$127.5k - $172.5k
...Medical, dental, and vision health plans with FSA or HSA... ...communities we serve Paid remote work expenses... ...educators, matchmakers, integrators, and advocates. We are... ...Summary: The Team Lead, Strategic Consultant... ...credit union, banking, payments, or related vendor industry...Remote workHealth InsuranceFull timeContract workFor subcontractorWork at officeLocal area$66.94k - $101.26k
...Payment Integrity Analyst The Payment Integrity Analyst is responsible for... ...or CMS guidelines. This is a remote position. ESSENTIAL... ...~ Preferred experience with health insurance denials and/or appeals... ...leveled roles (I, II, III, Senior, Lead, etc.) new hires may be...Remote workHealth InsuranceMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$112.7k - $193.2k
...improving the flow of health data and information to... ...for one of Optum Payment Integrity's Intelligent Fraud Detection... ...helps health plans and healthcare organizations... ...the flexibility to work remotely * from anywhere within... ...platformsExperience leading or mentoring other product...Remote workHealth InsuranceMinimum wageFull timeWork experience placementWork at officeLocal areaShift work- Envision Radiology is seeking a remote Billing Supervisor to join our team and lead the payments function. This role oversees daily billing operations, ERA posting... .../Healthcare or equivalent. Benefits include health plans, 401k, ESOP, and PTO. #J-18808-Ljbffr Envision...Remote jobHealth InsuranceMonday to Friday
$116k - $125k
...Lead Technical Program Manager This is a remote-first role that may require travel... ...implementations are planned and managed through... ...~ Healthcare, health-tech, or complex B... ...prior authorization, payment accuracy, and more... ...launching our Payment Integrity Suite, anchored by...Remote workHealth InsuranceFlexible hours$112k - $125k
...opportunity for an outstanding Lead Healthcare Analystto... ...a Series C digital health company. You will work... ...nuances, formulate plans, build and maintain... ...Pay & Perks: Fully remote opportunity with about... ...platform by launching our Payment Integrity Suite, anchored by...Remote workHealth InsuranceFull timeWork experience placementWork at officeFlexible hours- ...Business Development Specialist to drive the expansion of its payments ecosystem across LATAM and globally. This commission-based role focuses on merchant acquisition, local partnerships, PSP integrations, and growth initiatives for Bybit Pay, Card, and Fiat channels....Remote jobLocal areaOverseas
$64.83k - $85.09k
...hiring a COB Specialist to join our Payment Integrity team. Oscar is the first health insurance company built around a... ...Integrity. Work Location: This is a remote position, open to candidates who... ...time, paid parental leave, 401(k) plan participation, life and disability...Remote workHealth InsuranceFull timeContract workWork at office- ...opportunities. Responsibilities: Provide subject matter expertise on Payment Integrity edits, vendor edits, and reimbursement policies. Respond to... ...workflows and collaborating with stakeholders. Oscar Health Oscar is a health insurance company built around a full stack...Remote jobHealth Insurance
- JOB DESCRIPTION Job Summary This position supports Payment Integrity through the research and development of post-pay recovery concepts and... ...experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination...Remote jobHealth InsuranceWork at office
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