Supervisor of Payment Integrity

Network Health is seeking a Supervisor of Payment Integrity. This role provides leadership support to strengthen and sustain payment integrity efforts at Network Health by providing guidance, coordination and oversight of the team activities. The supervisor oversees the collection, reporting and analysis of data associated with claims and enrollment audit review activities, fraud waste and abuse special investigations and assures that findings are communicated with the appropriate business areas and that corrective action plans are implemented where necessary.Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha will be required occasionally for the position, including on first day.Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through FridayCheck out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.Job Responsibilities:Assumes responsibility for personnel related duties including interviewing, disciplinary actions, payroll and enforcing required rules and regulations, consulting with the director, as necessaryResponsible for accurate, timely and efficient review of scheduled auditsOversee fraud, waste and abuse special investigations and communicate with appropriate departments any findings and action stepsOversee payment accuracy and quality assurance audits and reviews, and communicate with appropriate departments any findings and action stepsPartners with other departments to identify, develop and implement new audit algorithms to improve payment accuracyProvide support and leadership to department through regular team meetings, one-on-one, and interim and annual performance review discussionsConducts all hiring, training, and time and performance management for the team. Consults with leader and Human Resources as necessaryParticipates in problem solving and prioritizing review activities and oversees the completion and reporting of review activities for service level agreements and communicating results with leadershipProvides leadership and evaluation of the team to help ensure productivity and continuous process improvementResponsible for the development and maintenance of a reporting dashboard that outlines the progress and status of all audits as well as their outcomesOversees and assists with the development of audit policies and proceduresJob Requirements:Bachelor’s degree or equivalent years of equivalent work experience required3 or more years health care or health insurance experience is required2 or more years working in a quality assurance or auditing role required1+ years’ experience in leadership or mentoring requiredKnowledge of health care industry practices and key health care compliance conceptsAbility to motivate and guide a team to reach established goalsEffectively communicate and report team performance results in a clear and concise formatNetwork Health is an Equal Opportunity Employer.Job SummaryRequisition Number: SUPER002356Job Category: OtherSchedule: Full-Time