Director, Payment Integrity - REMOTE EST OR CST

• At least 8 years of experience supporting health care operations, including 5 years payment integrity/claims experience, or equivalent combination of relevant education and experience.
• At least 3 years management/leadership experience.
• Managed care payor experience, preferably in Medicare/Medicaid government-sponsored programs.
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Excellent verbal and written communication skills.
• Microsoft Office suite and applicable software program(s) proficiency.

• Knowledge of CPT, HCPCS, ICD-10-CM, ICD-10-PCS, NCCI, DRG, and reimbursement methodologies.
• Strong understanding of healthcare claims processing, reimbursement methodologies, coding systems, and payment integrity principles.
• Experience developing and managing business requirements, process documentation, or operational specifications.
• Experience managing payment integrity concept governance, portfolio management, and health plan engagement functions.
• 5 years of leadership experience managing teams responsible for payment integrity analytics, claim configuration, claims auditing, or related functions.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V