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Director Payment Integrity Jobs in Michigan (NOW HIRING)

Trice Healthcare

Coding Payment Resolution Spec

Lansing, MI · On-site

$19 - $24.25/hr

... directed by the Supervisor Clinical / Coding Payment Resolution. * Interprets data, draws ... Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring ...

R1 RCM

Coding Integrity Specialist

Detroit, MI · On-site

$28.24 - $40.21/hr

As our Coding Integrity Specialist , you will works with the Coding Integrity Manager and Director ... payment programs and public reporting * Provide education/feedback to coders/coding managers ...

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Director Payment Integrity information

What does a director of payment integrity do?

A Director of Payment Integrity is responsible for overseeing programs and strategies that ensure accurate payments within a healthcare or insurance organization. This role focuses on identifying and preventing improper payments, such as overpayments or fraud, by analyzing claims data, implementing process improvements, and ensuring compliance with regulations. Directors of Payment Integrity work closely with other departments to optimize payment accuracy, reduce financial risk, and enhance overall operational efficiency. They may also lead teams, develop training, and report on key performance metrics related to payment integrity initiatives.

How does a director of payment integrity typically collaborate with cross-functional teams to ensure accurate claims processing?

A Director of Payment Integrity regularly works with teams such as claims, IT, compliance, and provider relations to develop and implement strategies that minimize payment errors and fraud. Collaboration often involves leading meetings to review audit findings, coordinating the integration of technology solutions, and ensuring all departments are aligned on regulatory requirements. This cross-team approach helps streamline workflows, enhances data accuracy, and supports continuous improvement initiatives to safeguard the organization's financial health.

What are the key skills and qualifications needed to thrive as a director of payment integrity, and why are they important?

To thrive as a Director of Payment Integrity, you need a strong background in healthcare claims management, analytics, and regulatory compliance, often supported by a bachelor's or master's degree in healthcare administration, business, or a related field. Expertise with claims processing systems, data analytics tools like SQL or SAS, and relevant certifications such as Certified Professional Coder (CPC) are commonly required. Exceptional leadership, strategic thinking, and communication skills help drive cross-functional initiatives and foster collaborative problem-solving. These competencies are crucial to effectively identify and mitigate payment inaccuracies, ensuring compliance and optimizing financial performance for healthcare organizations.

What is the difference between Director Payment Integrity vs Payment Integrity Analyst?

AspectDirector Payment IntegrityPayment Integrity Analyst
CredentialsBachelor's degree, often advanced certifications in healthcare or financeBachelor's degree, relevant certifications preferred
Work EnvironmentLeadership role overseeing teams and strategiesAnalytical role focused on data review and issue resolution
Employer & Industry UsageHealthcare payers, insurance companies, large healthcare organizationsHealthcare providers, insurance companies, claims processing units
Search & Comparison IntentUnderstanding managerial responsibilities and strategic oversightFocus on data analysis and claims review processes

The main difference between a Director Payment Integrity and a Payment Integrity Analyst lies in their level of responsibility and scope. The Director oversees teams, develops strategies, and manages overall payment integrity programs, while the Analyst focuses on data analysis, claims review, and issue resolution. Both roles require relevant healthcare or finance certifications, but the director's role is more strategic and leadership-oriented.

What are popular job titles related to Director Payment Integrity jobs in Michigan?

For Director Payment Integrity jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Director Payment Integrity jobs in Michigan look for?

The top searched job categories for Director Payment Integrity jobs in Michigan are:

What cities in Michigan are hiring for Director Payment Integrity jobs?

Cities in Michigan with the most Director Payment Integrity job openings:

Director Payment Integrity jobs near you
Infographic showing various Director Payment Integrity job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, 2% Temporary, 3% Contract, and 1% Nights. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Director Payment Operations - Michigan

Socket.dev

Flint, MI • On-site

$140 - $190/hr

Other

This job post has expired 4 days ago. Applications are no longer accepted.

Job description

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Director, Payment Operations, to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member.MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life.McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP,you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

Position Summary

The Director of Payment Operations provides strategic and operational leadership across the end-to-end revenue and claims life cycle, including Enrollment, Appeals & grievances, Claims, Encounters, Configuration, and Payment Integrity. This role is accountable for the accuracy, timeliness, compliance, and financial integrity of McLaren’s payment operations functions, ensuring seamless coordination from member/provider enrollment through claims adjudication, encounter submission, and payment recovery. This role serves as a critical cross-functional partner to Compliance, Finance, IT, Provider Network, and Clinical leadership, and represents Payment Operations in regulatory audits, executive reporting, and enterprise strategic planning.

QualificationsRequired
  • Bachelor’s degree in business administration, healthcare administration, or related field.
  • Eight (8) years of progressively more responsible health plan operations experience including claims processing, enrollment, appeals & grievances, or system configuration to ensure payment integrity, including five (5) years in a leadership role managing multiple functions and multi-disciplinary teams
Preferred
  • Master’s degree in business administration, healthcare administration, or related field.
  • Five (5) years’ experience driving measurable operational and financial improvement through process redesign, automation, and payment integrity programs.
  • Strong vendor management and contract negotiation experience.
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