IEHP

Director, Payment Integrity

IEHP

full-time

Posted on:

Location Type: Hybrid

Location: Rancho Cucamonga • California • United States

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Salary

💰 $154,128 - $204,214 per year

Job Level

Lead

About the role

  • Find joy in serving others with IEHP!
  • Provide strategic leadership and oversight for all Payment Integrity functions, ensuring payment accuracy, regulatory compliance, and cost containment.
  • Develop and drive the vision and strategy for payment integrity programs and operational excellence.
  • Partner across the enterprise to optimize reimbursement, prevent fraud, waste, abuse, and improve member affordability.
  • Ensure the financial sustainability and regulatory compliance of the organization by preventing, identifying, and recovering inappropriate healthcare payments across all lines of business.

Requirements

  • Minimum of seven(7) years of progressive healthcare administration experience in payment integrity, special investigations, or healthcare anti-fraud, inclusive of a minimum of two (2) years of experience with an HMO or managed care experience.
  • Proven leadership experience, mentoring, and developing a team at a leadership level
  • Experience in Vendor Partner Oversight; contracting and vendor management of external payment vendors and/or audit firms
  • Preferred: Medi-Cal and/or Medicare claims experience
  • Bachelor's degree in Business Administration, Accounting, or Healthcare from an accredited institution required
  • Preferred: Master’s degree in a related field from an accredited institution
Benefits
  • Competitive salary
  • State of the art fitness center on-site
  • Medical Insurance with Dental and Vision
  • Life, short-term, and long-term disability options
  • Career advancement opportunities and professional development
  • Wellness programs that promote a healthy work-life balance
  • Flexible Spending Account – Health Care/Childcare
  • CalPERS retirement 457(b) option with a contribution match
  • Paid life insurance for employees
  • Pet care insurance
Applicant Tracking System Keywords

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

Hard Skills & Tools
payment integrityhealthcare administrationvendor managementcontractingauditMedi-Cal claimsMedicare claims
Soft Skills
strategic leadershipmentoringteam developmentcollaborationcommunication
Certifications
Bachelor's degreeMaster’s degree