Director Payment Integrity Jobs in Racine, WI (NOW HIRING)

Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.  

Company Overview: 

Leading with our core values of Quality, Integrity, and Opportunity, MedInsight is one of the healthcare industry’s most trusted solutions for healthcare intelligence. Our company purpose is to empower easy, data-driven decision-making on important healthcare questions. Through our products, education, and services, MedInsight is making an impact on healthcare by helping to drive better outcomes for patients while reducing waste. Over 300 leading healthcare organizations have come to rely on MedInsight analytic solutions for healthcare cost and care management. 

MedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. 

Position Summary: 

MedInsight is hiring a Business Development Executive to lead new-logo acquisition and expansion revenue across our risk adjustment portfolio. This is a selling specialist role: you will own a national territory selling MedInsight’s risk adjustment software and analytics to health plans, provider organizations, ACOs, MSOs, and other risk-bearing entities.

Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance outcomes. You will sell to the leaders who own those outcomes (risk adjustment, coding, quality, finance, and compliance executives), and you will build credibility by understanding their priorities and engaging in meaningful business conversations rather than leading with product features.

This is a highly consultative, insight-led role that leverages Challenger-style selling principles. Reporting to the SVP of Sales & Growth and working alongside a peer group of BDEs, you will have dedicated support from marketing, sales development, and sales engineering. As MedInsight enters its next phase of growth, this is a high-visibility role with significant upside for career advancement.

 Primary Responsibilities: 

• Develop deep expertise in MedInsight’s risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
• Build and execute a strategic national territory plan across health plans, provider organizations, ACOs, MSOs, and risk-bearing entities through targeted research, outbound prospecting, and insight-led engagement.
• Identify, develop, and rigorously qualify opportunities using a structured sales methodology, mapping decision-makers and influencers across executive, clinical, financial, operational, and compliance functions.
• Drive multi-threaded deal progression with stakeholders including C-suite executives, risk adjustment and coding/CDI leaders, quality and finance leaders, operations, and IT.
• Lead consultative conversations that surface explicit and unrecognized needs across RAF performance, coding accuracy, documentation integrity, audit readiness, provider engagement, and both retrospective and prospective risk adjustment.
• Deliver compelling commercial narratives that challenge the status quo and position MedInsight as a strategic solution for improving risk capture, compliance, operational efficiency, and reimbursement outcomes.
• Partner closely with Marketing on outbound opportunity creation, campaign follow-up, event engagement, and account-based prospecting.
• Collaborate with Sales Engineering, Product, Client Success, and Subject Matter Experts to deliver tailored demonstrations and ROI-driven business cases tied to measurable outcomes rather than features alone.
• Consistently achieve and exceed quota and pipeline-generation targets, and maintain accurate forecast, opportunity, account, and activity data in Salesforce to support disciplined territory management.
  

Preferred Skills and Experience: 

• 8 or more years of full-cycle new-business development in complex, consultative enterprise sales, preferably in healthcare technology, analytics, SaaS, or payment integrity / risk adjustment solutions.
• Demonstrated success selling into healthcare payer, provider, and/or risk-bearing organizations, navigating complex buying groups and long sales cycles.
• Direct experience selling risk adjustment, coding, CDI, quality, value-based care, population health, or related analytics solutions is strongly preferred.
• Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly preferred.
• Proven track record of building pipelines from scratch and executing territory plans in greenfield, competitive, or underpenetrated markets.
• Demonstrated success negotiating and closing complex enterprise agreements with senior decision-makers, including CFOs, CIOs, COOs, CMOs, Chief Population Health Officers, and VP-level risk adjustment and compliance leaders.
• Skilled at partnering with Sales Engineering and cross-functional teams to deliver outcome-oriented demonstrations and solution positioning.
• Bachelor’s degree in business, healthcare administration, finance, economics, public health, or a related field preferred; advanced degree (MBA, MHA, MPH, or similar) a plus. Neither is required.
  

Key Competencies: 

• Challenger Mindset: Leads with insight, teaches prospects something new about their risk adjustment performance, and creates urgency for change.
• Consultative Seller: Uncovers root business issues and ties solutions to measurable financial, compliance, and operational outcomes.
• Analytical & Strategic: Synthesizes market, financial, and operational data into sharp, customer-specific account strategies.
• Entrepreneurial: Resourceful and proactive; creates momentum, opens doors, and builds pipeline in ambiguous, evolving markets.
• Emotionally Intelligent: Builds trust quickly, navigates complex stakeholder dynamics, and turns feedback into growth.
• Intellectually Curious: Stays ahead of shifting regulations, reimbursement models, and emerging market opportunities.
• Effective Communication: A clear, confident, persuasive communicator in writing and in person, including at the executive level.
• Organized & Resilient: Manages multiple opportunities and internal partnerships with precision, follow-through, and persistence.

Location

This role can be remote within the U.S. The expected application deadline for this job is August 30, 2026. 

Compensation

The overall salary range for this role is $104,900 - $199,065. For candidates residing in: 

• Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia, the salary range is $120,635 - $199,065.  
• All other locations the salary range is $104,900 - $173,100. 

A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. 

What makes this a great opportunity? 

• Join an innovative, high growth company with a solid industry track record 

• Bring your expertise and ideas to directly impact and help build the next generation of MedInsight products and solutions 

• Be recognized for your contributions and impact
• Work for a company that values your wellbeing and professional growth, offering a flexible work environment, generous benefits package, and investment in the development of your career 

Benefits 

We offer a comprehensive benefits package designed to support employees’ health, financial security, and well-being. Benefits include:

• Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners
• Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges
• 401(k) Plan – Includes a company matching program and profit-sharing contributions.
• Discretionary Bonus Program – Recognizing employee contributions
• Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses
• Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis
• Holidays – A minimum of 10 paid holidays per year
• Family Building Benefits – Includes adoption and fertility assistance
• Paid Parental Leave – 11 weeks of paid leave for employees who meet eligibility criteria. 
• Life Insurance & AD&D – 100% of premiums covered by Milliman
• Short-Term and Long-Term Disability – Fully paid by Milliman

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran. 

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