Develop and implement comprehensive payment accuracy QA policies, procedures, and tracking mechanisms to ensure a "gold standard" for payment integrity.
Oversee the execution of quality assurance audits on payment transactions, evolving the process from manual sampling to scalable and data-driven, risk-based auditing.
Act as the primary point of contact and subject matter expert for all external client audits; manage the end-to-end audit lifecycle, from initial data requests to the presentation of findings, ensuring Maven’s internal administrative excellence is clearly demonstrated.
Lead cross-functional discussions to categorize findings and conduct deep-dive root cause analyses, ensuring that errors are not just identified but structurally prevented.
Collaborate cross-functionally to implement corrective action plans and hold partners accountable to performance SLAs.
Serve as the business owner for payment integrity tools; partner with Product/Engineering to design application enhancements and automated fail-safes.
Recruit, onboard, and manage a team of Payments Integrity & QA analysts, fostering a culture of high attention to detail and continuous operational improvement.

Requirements

8+ years in payment/claims analysis or auditing, with a strong preference for healthcare payer or insurance backgrounds.
Proven track record of managing and coaching teams, with the ability to build influential relationships with executive leadership.
Extensive experience using data and analytics tools (e.g., Looker) to identify patterns and drive business judgment.
Significant experience "creating order from chaos" and building processes in a fast-paced, entrepreneurial environment.
Proficiency in Asana, Jira, and Looker to manage workflows and report on program health preferred.

Benefits

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Applicant Tracking System Keywords

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Hard Skills & Tools

payment accuracy QAquality assurance auditsdata-driven auditingroot cause analysiscorrective action planspayment integritydata analyticsprocess buildingteam managementcoaching

Soft Skills

attention to detailoperational improvementrelationship buildingcross-functional collaborationexecutive communicationleadershipinfluencing