Senior Payment Integrity Analytics Lead (Remote)
Inland-Empire-Health-Plan-
- Remote job
IEHP in Rancho Cucamonga is seeking a Senior Payment Integrity Analyst to lead daily PI operations, audits, and reporting. The role includes mentoring junior analysts and driving cost containment and regulatory compliance, with a focus on payment integrity and provider claims accuracy. Responsibilities include data mining with SQL/Excel, dashboard development, and collaboration with providers to resolve payment discrepancies. Strong experience in CMS/DHCS and auditing is required. #J-18808-Ljbffr Inland-Empire-Health-Plan-
- Inland Empire Health Plan (IEHP) is seeking a Senior Payment Integrity Program Development Specialist in Rancho Cucamonga, CA. The role drives research... ...into actionable outcomes, enhance FWA detection, and lead cost-avoidance strategies across operations. #J-18808-Ljbffr...Remote jobSenior
- PacificSource is seeking a Senior Fraud, Waste and Abuse (FWA) Specialist to lead the organization’s FWA program, enhance payment integrity, and ensure regulatory compliance. The role requires... ...in Medicare/Medicaid and strong analytical capabilities. #J-18808-Ljbffr...Remote jobSenior
- Jobtailor seeks a lead-level analyst to drive payment integrity operations for health plans in California. You will QA junior analysts, lead vendor reporting, and collaborate on strategies to improve financial performance and cost containment. The role requires five years...Senior
- Inland Empire Health Plans (IEHP) seeks a Senior Payment Integrity Program Development Specialist to lead research, analysis, and development of initiatives that improve payment accuracy and regulatory compliance. You will evaluate cost trends, claims patterns, and industry...Senior
- ...health services company, seeks a Senior Product Manager for Professional Claims Review - Payment Integrity. You will define strategy,... ...teams including engineering, analytics, and GTM to deliver... ...client value. This role offers remote work anywhere in the U.S. with...Remote jobSeniorWork at office
- PacificSource is seeking a Senior Fraud, Waste and Abuse (FWA) Specialist to lead the Payment Integrity and FWA programs, ensuring compliance and effective fraud prevention... ...operations. This senior role requires strong analytical skills and the ability to lead cross-...Remote jobSenior
- Optum is seeking a Senior Product Manager to define and execute... ...Review solutions within Optum Payment Integrity. You will own the product... ...You'll partner with AI/ML, analytics, and data science teams to deliver... ...-functional leadership. Remote work across the U.S. #J-188...Remote workSenior
- ...approach to R&DJob Title: Senior Director, Portfolio Integration LeadOverview Cancer is unrelenting... ...The Portfolio Integration Lead (PIL) is a senior role in... ...such as AI-enabled analytics where appropriate.External... ...with a mix of on-site and remote work. Remote or fully home...Remote workSeniorFull timeLocal areaWork from homeRelocation
- Real Chemistry is seeking an experienced Senior Analyst, Beyond Insights (Omnichannel Analytics) to scale our business intelligence practice for media and omnichannel... ...teams. You will leverage a new data partner set to integrate media and channel data into Tableau dashboards and...Remote jobSenior
- Ziply Fiber seeks a Senior Manager to lead billing and payment platforms across a multi-system environment, focusing on platform integrity, automation, and AI-first modernization. You will own end-to-end processes from activation to posting, with emphasis on minimizing...Remote jobSenior
- Acorn seeks a Senior Media Analyst to solve problems through data analytics and deliver insights for influencer marketing campaigns. You will support enterprise... ..., learn new platforms quickly, and maintain data integrity while providing actionable recommendations. #J-1...Remote jobSenior
$112.7k - $193.2k
...Growing together.The Senior Product Manager is a... ...strategy for one of Optum Payment Integrity's Intelligent Fraud... ...of advanced analytics, AI, and deep healthcare... ...flexibility to work remotely * from anywhere within... ...platformsExperience leading or mentoring other product...Remote workSeniorMinimum wageFull timeWork experience placementWork at officeLocal areaShift work- Blue Cross and Blue Shield of North Carolina is seeking a strategic analytics partner for the Special Investigations Unit and Payment Integrity teams. You will deliver business intelligence, financial reporting, and operational insights, combining data analysis with stakeholder...
$112.7k - $193.2k
...Growing together.The Senior Product Manager is a... ...strategy for one of Optum Payment Integrity's Facility Claim... ...combination of advanced analytics, AI, and deep... ...flexibility to work remotely * from anywhere within... ...initiativesExperience leading cross-functional initiatives...Remote workSeniorMinimum wageFull timeWork experience placementWork at officeLocal areaShift work$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote) CGI is seeking a results-oriented Senior Analyst to join our growing... ...domain expertise with advanced analytics to ensure payment accuracy and... ...Validation: Design validation datasets and lead rigorous pre-deployment user...Remote workSeniorLocal area- Blu Omega LLC is seeking a Senior Health Economist and Task Lead to drive high-visibility healthcare payment model initiatives. You will blend hands-on analytics (SQL/Python and claims data) with delivery... ...findings to varied audiences. Remote start with potential onsite in...Remote workSenior
- Franchise World Headquarters, LLC in Miami, FL, is seeking a Sr. Analyst, Fraud & Payment Analytics to detect, analyze, and prevent fraud across payment channels and regions. The role partners with vendors and internal teams to implement mitigations and optimize processes...Senior
$117.3k - $195.5k
...Support KPI definition and lead dashboard design... ...stakeholders of different seniority levels, including... ...support to other Medical Analytics teams Provide ad-hoc... ...CA; Boulder, CO; US - remote; Montreal, Canada Eligible... ...Act Pfizer reports payments and other transfers of...Remote workSeniorRelocation packageFlexible hours$110.5k - $150k
...partner is looking for a Payment Integrity Program Development Senior Manager – Clinical & Facility... ...provider friction. Lead cross-functional policy... ...platforms. Research and analytical skills: Ability to... ...~401(k) program . ~ Remote work within the United States...Remote workSeniorFull timeLocal area- Unlimit is seeking a Payment Methods Specialist / Senior Payment Methods Specialist to lead the full lifecycle of Alternative Payment Methods (APMs). This role requires... ...with technical teams, and excellent analytical skills. You will ensure each payment method's reliability...SeniorWork at office
$108.88k - $163.32k
A leading global food retailer is seeking a professional to provide data analytics support for electronic customer payment transactions, both in-store and digital. The role involves reporting, vendor negotiations, and strategic planning to enhance payment methods. Ideal...Senior- Optum is seeking a Sr. Technical Product Manager for Payment Integrity to lead strategy and delivery for scalable platform capabilities. This remote role partners with engineering, architecture, operations and business leaders to drive value across multiple portfolios....Remote jobSenior
- Centene Corporation seeks a senior leader to supervise the Coding & Clinical Review team within Payment Integrity, ensuring accurate DRG assignments and audit outcomes. This remote role drives quality, efficiency, and adherence to AHIMA standards while coordinating cross...Remote job
- Tri-State Generation and Transmission Association, Inc. is looking for an Integration and Analytics Manager in Westminster, Colorado. This role involves developing and leading integration strategies, managing a technical team, and ensuring secure data interactions across...Remote jobFlexible hours
$105.84k - $245k
...NTT America, Inc. is seeking a Senior Informatica ETL Developer for a remote position. The ideal candidate will have... ...strong SQL skills, and the ability to lead data engineering efforts. This role involves data analysis, integration, and support of data management processes...Remote workSenior- A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations of the payment integrity team. Responsibilities include managing... ...a focus on improving service delivery. This remote position requires strong experience in claims processing...Remote jobDaily paid
$110.5k - $150k
...bit about this role: As our Senior Payment Integrity Program Development Manager... ...-to-End Concept Ownership: Lead multi-phased concept... ...structured logic, paired with the analytical ability to read, interpret,... ...development. #LI-DS1 #LI-Remote Salary range: $110,500 - $1...Remote workSeniorFull timeContract workInternshipLocal area- Inland Empire Health Plans (IEHP) is seeking a Senior Payment Integrity Analyst to lead a team of analysts and oversee daily operations of payment integrity initiatives. You will ensure accuracy of provider claims and drive cost avoidance through remediation plans. Reporting...SeniorDaily paid
- CorVel Corporation seeks a Payment Integrity Analyst (Team Lead) to supervise the Policy and Payment Integrity (PPI) team while overseeing audits per... ...staff training, and timely completion of audits, with a remote work arrangement. Strong knowledge of CMS policies, ICD-...Remote job
- A leading technology recruitment firm is looking for a Business Development Manager to join... ...new business leads within the regulated payments sector in the US and Canada. The ideal candidate... ...exceeding sales targets. The position is remote, offering flexibility for candidates on...Remote jobSenior
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