Simsy Ventures

Program Director – WTC Health Program, COB & Recovery Program

Simsy Ventures

full-time

Posted on:

Location Type: Remote

Location: United States

Visit company website

Explore more

✨ AI Apply
Apply

Job Level

Lead

About the role

  • Serve as the primary liaison between the organization and the WTC Health Program, including communication with Program Management, Contracting Officer (CO), and Contracting Officer Representative (COR)
  • Provide end-to-end oversight of contract operations, ensuring all deliverables meet quality, timeliness, and compliance standards
  • Lead execution of a comprehensive cost avoidance, COB, and recovery program across pre- and post-payment processes
  • Ensure accurate and timely submission of reports, deliverables, and ad hoc requests
  • Oversee implementation and adherence to a robust quality assurance program
  • Manage cross-functional teams supporting:
  • Insurance identification and verification
  • Coordination of benefits (COB)
  • Claims recovery (OHI & Workers’ Compensation)
  • Payment integrity and fraud, waste, and abuse (FWA) efforts
  • Maintain effective communication channels with internal staff and external stakeholders, including government entities and program partners
  • Drive performance monitoring, operational improvements, and cost containment strategies
  • Ensure compliance with federal regulations, HIPAA requirements, and contractual obligations
  • Foster and maintain strong business relationships with all program stakeholders

Requirements

  • Minimum 10+ years of experience in:
  • Coordination of Benefits (COB)
  • Claims recovery / payment integrity
  • Federal healthcare program management
  • Proven experience managing large, complex government contracts or programs
  • Strong knowledge of:
  • Healthcare claims processing
  • Insurance coordination (OHI, Workers’ Compensation)
  • Payment integrity and recovery operations
  • Demonstrated leadership experience managing cross-functional teams and stakeholders
  • Experience ensuring contract compliance, reporting accuracy, and SLA performance
  • Excellent communication and stakeholder management skills.
Benefits
  • 100% remote/offsite
  • Occasionally travel (estimated 4+ trips annually)
  • Travel may include Washington, DC; New York City; Cincinnati; Atlanta
Applicant Tracking System Keywords

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

Hard Skills & Tools
Coordination of Benefits (COB)Claims recoveryPayment integrityHealthcare claims processingInsurance coordinationContract complianceReporting accuracySLA performanceCost avoidanceQuality assurance
Soft Skills
LeadershipCommunicationStakeholder managementOperational improvementsRelationship buildingCross-functional team managementPerformance monitoringTimelinessCompliance adherenceProblem-solving