Senior Payment Integrity Manager

Position Overview

• Location Type: Not specified
• Job Type: Full-time
• Salary: $104,500 - $155,000 annually

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. We are a new kind of all-in-one healthcare company, combining compassion, health insurance, clinical care, service, and technology to deliver a complete and integrated healthcare solution. Founded in 2017, we serve members across the United States.

The Senior Manager, Payment Integrity is a senior operational leader responsible for overseeing the strategy, execution, and performance optimization of the organization's payment integrity programs. This role ensures that both prepayment and post-payment audit functions are designed and delivered to achieve savings, reduce error rates, and align with regulatory requirements. The Senior Manager drives operational excellence, manages escalations, collaborates cross-functionally to improve end-to-end audit workflows, and provides guidance to internal teams and external partners.

Requirements

• Bachelor's degree and a minimum of 6 years of relevant experience
• Understanding of US healthcare
• Understanding of claims adjudication, revenue cycle management, and payment integrity
• Ability to collaborate, communicate, and influence horizontally and vertically
• Being comfortable in both leadership and execution roles
• Being comfortable with ambiguity and a startup environment
• Ability to incorporate company vision, mission, and values in decision making
• Certified Professional Coder (CPC) certification (Desired)

Responsibilities

• Lead and optimize the execution of enterprise payment integrity initiatives, with accountability for performance across prepay and postpay claims review programs.
• Translate organizational strategy into operational action plans, ensuring alignment with savings goals, audit integrity, and regulatory compliance.
• Partner with analytics, finance, compliance, and tech to identify new audit opportunities, improve processes, and develop scalable solutions.
• Oversee the health of audit pipelines by ensuring work inflow and outflow are properly forecasted, balanced, and executed.
• Monitor program KPIs such as savings, throughput, adjustment timeliness, and audit yield. Take corrective action when performance falls short.
• Use data to identify root causes of inefficiencies or payment errors and lead the development of solutions to reduce future risk.
• Serve as a senior escalation point for complex issues involving claims adjustments, provider disputes, and operational bottlenecks.
• Collaborate with departments such as Claims, Appeals, Provider Relations, and Medical Management to troubleshoot issues and implement improvements across the payment life cycle.

Company Information

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Compensation

Our salary ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, etc.