Payment Integrity Manager

Elevance Health

Carelon Payment Integrity Manager responsible for claims payment accuracy and managing fraud compliance. Leading inquiries and responses while developing processes and reports.

Posted 7/14/2026full-timeOverland Park • Kansas • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims payment accuracy, regulatory compliance, and project management within the healthcare sector. Proficient in developing reports and presentations while leading teams to ensure effective process execution.

Highest-signal resume keywords

Claims Payment ManagementRegulatory Compliance EvaluationLeadership ExperienceFraud, Waste And Abuse ExpertisePayment Integrity Knowledge

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Process Flow DocumentationProject PlanningData AnalysisPerformance Guarantee ReviewHealthcare Reform Knowledge

Soft Skills

CommunicationCoordinationProblem-Solving

Tools & Technologies

GBD FacetsClaims Systems

Industry Keywords

Healthcare AdministrationBusinessFinanceNursingEngineering

About the role

Key responsibilities & impact

Ensure the accuracy of claims payment through management of a robust process
Coordinate and respond to inquiries from executives
Handle the processing and management of Payment Integrity waivers
Assist in preparing responses to Requests for Proposals across all lines of business
Document process flows accurately
Help with preparing presentations
Review and approve performance guarantees
Evaluate regulatory compliance and Health Care Reform changes
Monitor provisions of the compliance plan
Develop and analyze monthly reports
Develop project plans and oversee project execution

Requirements

What you’ll need

Requires a BA/BS in business, engineering, nursing, finance, or healthcare administration
Minimum of 5 years related work experience
Minimum of 2 years leadership experience
2-5 years of experience with Fraud, Waste and Abuse preferred
Experience with payment integrity preferred
Familiarity with claims systems and processes preferred
Experience with GBD Facets preferred

Benefits

Comp & perks

merit increases
paid holidays
Paid Time Off
incentive bonus programs
medical benefits
dental benefits
vision benefits
short and long term disability benefits
401(k) +match
stock purchase plan
life insurance
wellness programs
financial education resources