Senior Manager, Payment Integrity Strategy and Operations

Health Care Service Corporation

Sr. Manager responsible for Payment Integrity Strategy and Operations at HCSC.

Posted 5/29/2026full-timeChicago • Illinois, Montana, New Mexico, Oklahoma, Texas • 🇺🇸 United StatesSenior💰 $102,000 - $184,300 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

process improvementprocess reengineeringdata collectionmetric definitionroot cause analysisContinuous Quality Improvement (CQI)change managementpolicy writingdocumentation preparationauditing

Soft Skills

leadershipnegotiationverbal communicationwritten communicationorganizational skillsdetail orientationinterpersonal skillsconsensus buildingprofessional presentationdecision making

Industry Keywords

health care quality improvementhealth care accreditationhealth care operationshealth insurance industryNCQAURACAAAHCregulatory requirementsbusiness process managementbest practice standards

About the role

Key responsibilities & impact

Leading the Process Leaders/Process Stewards in planning, defining, developing, testing, documenting, analyzing results and/or implementing process improvement and process reengineering opportunities
Leading and supporting business process activities and methods to the Super Process Leaders/Process Steward
Leading team activities, deliverables, and issue resolution
Leading key activities including data collection, metric definition and analysis, and root cause analysis
Supporting development and evolution of HCSC business process management methodology identifying best practice standards, guidelines, procedures and tools for analyzing, designing, and implementing business process initiatives
Ability to travel

Requirements

What you’ll need

Bachelor’s degree
8 years of experience in health care quality improvement, health care accreditation, health care operations, or combination thereof
12 years of experience in health care quality improvement, health care accreditation, health care operations, or combination thereof, including 8 years of experience in the health insurance industry with large, multi-state payer(s)
3 years of leadership or management experience
Experience with Continuous Quality Improvement (CQI) concepts, Strategy, and Change Management concepts
Experience with external accrediting agency requirements (i.e., NCQA, URAC, AAAHC)
Analytical skills and negotiation skills
Verbal and written communication skills including leadership skills, organizational skills and detail-orientation, interpersonal skills, consensus building skills, professional presentation skills and decision-making skills
Experience preparing documentation for auditors or project management
Knowledge and understanding of the health care industry and regulatory requirements
Experience writing policies and procedures

Benefits

Comp & perks

Health insurance
401(k) savings plan
Pension plan
Paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement