Senior Director Payment Integrity Operations Full Time

This leadership role offers the opportunity to drive operational excellence within a fast-paced healthcare technology environment focused on payment integrity and business transformation. The position oversees large-scale operational functions, client delivery, and process optimization initiatives that directly impact organizational growth and service quality. You will collaborate cross-functionally with senior stakeholders, lead high-performing teams, and shape scalable operational strategies across complex healthcare workflows. The role combines strategic planning with hands-on execution, requiring strong expertise in operational leadership, client engagement, and performance improvement. This is an ideal opportunity for a results-driven leader who thrives in dynamic environments and enjoys building efficient, client-centric operations. With broad visibility across the organization, this position plays a key role in driving innovation, operational scalability, and long-term business success.

Accountabilities

• Lead and oversee business operations for payment integrity programs, ensuring scalable, high-quality service delivery aligned with operational and client objectives.
• Support client engagements, RFP/RFI responses, and intake processes by developing tailored operational solutions and cost strategies.
• Drive operational transformation initiatives focused on process improvement, workforce optimization, service quality, and productivity enhancement.
• Partner closely with cross-functional leaders to strengthen operational excellence, improve service outcomes, and support business growth initiatives.
• Develop KPIs, reporting structures, and performance benchmarks to monitor operational effectiveness and continuous improvement efforts.
• Ensure compliance with regulatory, accreditation, client, and internal governance requirements across all operational activities.
• Lead, mentor, and develop high-performing teams while fostering a collaborative, accountable, and customer-focused culture.
• Manage operational planning, risk mitigation, scheduling, and escalation management to ensure service levels and client expectations are consistently exceeded.
• Present operational updates, improvement strategies, and performance insights to executive leadership and external stakeholders.
• Support strategic initiatives, business expansion efforts, and organizational alignment within a matrixed and evolving environment.

Requirements

• Bachelor’s degree in business, healthcare, operations, or a related field required; Master’s degree preferred.
• 10+ years of leadership experience in operations management, healthcare administration, consulting, or related environments.
• Strong expertise in healthcare payment operations, adjudication workflows, payment integrity, or health plan operations preferred.
• Experience leading operational transformation, implementations, transitions, or process optimization initiatives.
• Demonstrated success managing operational budgets, workforce planning, and performance improvement strategies.
• Proven leadership capabilities with experience hiring, mentoring, and developing high-performing teams.
• Excellent analytical, organizational, problem-solving, and decision-making skills.
• Strong communication and executive presentation abilities with experience interacting directly with clients and senior leadership.
• Familiarity with Lean Six Sigma, PMP, CPP, or similar operational excellence methodologies is highly valued.
• Advanced understanding of operational metrics, technology-enabled process improvements, and software implementation initiatives.
• Ability to thrive in fast-paced, matrixed environments while managing multiple priorities and stakeholder relationships effectively.
• Willingness to travel as needed and collaborate across global or distributed teams.

Benefits

• Competitive base salary ranging from $160,000 to $190,000 annually, based on experience and qualifications.
• Eligibility for discretionary bonus programs.
• Comprehensive medical, dental, and vision insurance coverage.
• Life insurance and disability benefits.
• 401(k) retirement savings plan.
• Paid family leave and generous paid time off package.
• 9 paid holidays annually.
• Fully remote work flexibility within the United States.
• Opportunity to lead high-impact operational initiatives in a growing healthcare technology environment.
• Collaborative culture focused on innovation, leadership development, and operational excellence.

How Jobgether Works

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role’s core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.