Experience within Payment Integrity, health plan, payer-side, or managed care operations. * Familiarity with CMS programs, regulatory requirements, and enforcement priorities impacting claims and ...
Experience within Payment Integrity, health plan, payer-side, or managed care operations. * Familiarity with CMS programs, regulatory requirements, and enforcement priorities impacting claims and ...
SVP, Sales - Payment Integrity Solutions
Phoenix, AZ · On-site +1
Maintain disciplined pipeline management, accurate forecasting, and detailed CRM documentation to ... Employee Assistance Program that includes professional counseling, referrals, and additional ...
SVP, Sales - Payment Integrity Solutions
Phoenix, AZ · On-site +1
Maintain disciplined pipeline management, accurate forecasting, and detailed CRM documentation to ... Employee Assistance Program that includes professional counseling, referrals, and additional ...
Program Manager Revenue Integrity
$39.18 - $58.28/hr
Job Summary and Responsibilities As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research ...
Program Manager Revenue Integrity
$39.18 - $58.28/hr
Job Summary and Responsibilities As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research ...
Program Manager Revenue Integrity
Phoenix, AZ · On-site
$39.18 - $58.28/hr
Job Summary and Responsibilities As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research ...
Program Manager Revenue Integrity
Phoenix, AZ · On-site
$39.18 - $58.28/hr
Job Summary and Responsibilities As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research ...
Program Manager Revenue Integrity
Phoenix, AZ · On-site
$39.18 - $58.28/hr
Job Summary and Responsibilities As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research ...
Program Manager Revenue Integrity
Phoenix, AZ · On-site
$39.18 - $58.28/hr
Job Summary and Responsibilities As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research ...
As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research patient billing practices across ...
As a Program Manager for Revenue Integrity you will offer subject-matter expertise within internal revenue cycle systems to ensure efficient and compliant research patient billing practices across ...
... payment integrity, or benefits leadership audiences. · Structured sales development processes, account-based prospecting, CRM discipline, and sequence-based outreach. What Success Looks Like In this ...
Quick apply
... payment integrity, or benefits leadership audiences. · Structured sales development processes, account-based prospecting, CRM discipline, and sequence-based outreach. What Success Looks Like In this ...
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and ... Care, Payment Integrity, Vendor Partnerships, etc.) REQUIRED QUALIFICATIONS Required Work ...
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and ... Care, Payment Integrity, Vendor Partnerships, etc.) REQUIRED QUALIFICATIONS Required Work ...
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and ... Care, Payment Integrity, Vendor Partnerships, etc.) REQUIRED QUALIFICATIONS Required Work ...
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and ... Care, Payment Integrity, Vendor Partnerships, etc.) REQUIRED QUALIFICATIONS Required Work ...
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and ... Care, Payment Integrity, Vendor Partnerships, etc.) REQUIRED QUALIFICATIONS Required Work ...
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and ... Care, Payment Integrity, Vendor Partnerships, etc.) REQUIRED QUALIFICATIONS Required Work ...
Program Manager
Chandler, AZ · On-site
We work collaboratively and with integrity, doing business the right way. For more than a century ... May manage projects and programs that cross multiple departments/regions throughout the company.
Program Manager
Chandler, AZ · On-site
We work collaboratively and with integrity, doing business the right way. For more than a century ... May manage projects and programs that cross multiple departments/regions throughout the company.
We work collaboratively and with integrity, doing business the right way. For more than a century ... May manage projects and programs that cross multiple departments/regions throughout the company.
We work collaboratively and with integrity, doing business the right way. For more than a century ... May manage projects and programs that cross multiple departments/regions throughout the company.
Program Manager
Casa Grande, AZ · On-site
$70K/yr
The Program Manager is responsible for supporting and monitoring the delivery of high quality ... integrity and contractual compliance. * Interview, hire, train, and directly supervise staff at ...
Program Manager
Casa Grande, AZ · On-site
$70K/yr
The Program Manager is responsible for supporting and monitoring the delivery of high quality ... integrity and contractual compliance. * Interview, hire, train, and directly supervise staff at ...
Program Manager
Peoria, AZ · On-site
The Program Manager will also create and maintain project and product roadmaps, facilitate ... Personal integrity in all areas of life * Must be, or willing to become a participating member of ...
Quick apply
Program Manager
Peoria, AZ · On-site
The Program Manager will also create and maintain project and product roadmaps, facilitate ... Personal integrity in all areas of life * Must be, or willing to become a participating member of ...
Program Manager
Chandler, AZ · On-site
We work collaboratively and with integrity, doing business the right way. For more than a century ... May manage projects and programs that cross multiple departments/regions throughout the company.
Program Manager
Chandler, AZ · On-site
We work collaboratively and with integrity, doing business the right way. For more than a century ... May manage projects and programs that cross multiple departments/regions throughout the company.
Program Manager
Peoria, AZ · On-site
The Program Manager will also create and maintain project and product roadmaps, facilitate ... Personal integrity in all areas of life * Must be, or willing to become a participating member of ...
Program Manager
Peoria, AZ · On-site
The Program Manager will also create and maintain project and product roadmaps, facilitate ... Personal integrity in all areas of life * Must be, or willing to become a participating member of ...
The Program Manager will also create and maintain project and product roadmaps, facilitate ... Personal integrity in all areas of life * Must be, or willing to become a participating member of ...
The Program Manager will also create and maintain project and product roadmaps, facilitate ... Personal integrity in all areas of life * Must be, or willing to become a participating member of ...
Program Manager
Tempe, AZ · Hybrid
We work collaboratively and with integrity, doing business the right way. For more than a century ... Responsible for planning and managing programs and projects to achieve product delivery, customer ...
Program Manager
Tempe, AZ · Hybrid
We work collaboratively and with integrity, doing business the right way. For more than a century ... Responsible for planning and managing programs and projects to achieve product delivery, customer ...
Program Manager
Phoenix, AZ · Hybrid
We work collaboratively and with integrity, doing business the right way. For more than a century ... Responsible for planning and managing programs and projects to achieve product delivery, customer ...
Program Manager
Phoenix, AZ · Hybrid
We work collaboratively and with integrity, doing business the right way. For more than a century ... Responsible for planning and managing programs and projects to achieve product delivery, customer ...
Program Manager
Chandler, AZ · On-site
We work collaboratively and with integrity, doing business the right way. For more than a century ... Responsible for planning and managing programs/projects to meet product delivery, customer service ...
Program Manager
Chandler, AZ · On-site
We work collaboratively and with integrity, doing business the right way. For more than a century ... Responsible for planning and managing programs/projects to meet product delivery, customer service ...
Payment Integrity Program Manager information
What is the difference between Payment Integrity Program Manager vs Payment Recovery Specialist?
| Aspect | Payment Integrity Program Manager | Payment Recovery Specialist |
|---|---|---|
| Credentials | Typically requires a bachelor’s degree in healthcare, finance, or related fields; certifications like CPC or CPAT are common | Often requires similar healthcare or finance background; certifications like CPC or CPT may be preferred |
| Work Environment | Works within healthcare organizations or insurance companies, focusing on program oversight and compliance | Operates in claims departments or recovery units, focusing on identifying and recovering overpayments |
| Employer & Industry | Healthcare payers, insurance companies, government programs | Insurance companies, healthcare providers, third-party recovery firms |
The Payment Integrity Program Manager oversees programs to prevent improper payments, ensuring compliance and efficiency. In contrast, the Payment Recovery Specialist focuses on identifying and recovering overpaid claims. While both roles require healthcare and finance knowledge, the Program Manager has broader responsibilities related to program management, whereas the Recovery Specialist concentrates on claims recovery activities.
What are popular job titles related to Payment Integrity Program Manager jobs in Arizona? For Payment Integrity Program Manager jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Payment Integrity Program Manager jobs in Arizona look for? The top searched job categories for Payment Integrity Program Manager jobs in Arizona are:
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Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 26 days ago
Key responsibilities
Serve as the primary compliance liaison for Payment Integrity and Payment Operations, providing strategic guidance on regulatory and operational compliance matters.
Interpret, analyze, and operationalize applicable regulatory requirements, including the No Surprises Act (NSA), Fraud, Waste & Abuse (FWA) laws, CMS requirements, and state Department of Insurance (DOI) regulations impacting payment and billing practices.
Provide compliance oversight and guidance related to payment workflows, reimbursement methodologies, claims administration processes, and product development initiatives.
Job description
Vālenz® Health is the platform to simplify healthcare - the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey - from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.
About This Opportunity:
As a Sr. Product Compliance Specialist - Payment Integrity, you'll support Payment Integrity and Payment Operations as the primary compliance lead for regulatory requirements impacting claims, billing, reimbursement, and payment activities. You'll provide risk-based compliance oversight for areas including the No Surprises Act (NSA), Fraud, Waste & Abuse (FWA), regulatory change management, operational initiatives, and other payment-related processes.
You'll partner closely with Product, Operations, and Corporate Compliance teams to support policy governance, compliance training, issue intake management, and ongoing efforts to ensure compliance with applicable state and federal regulations.
Things You'll Do Here:
What You'll Bring to the Team:
A plus if you have...
Where You'll Work: This is a fully remote position, and we'll provide all the necessary equipment!
Why You'll Love Working Here
Valenz is proud to be recognized by Inc. 5000 as one of America's fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare.With this commitment, you'll find an engaged culture - one that stands strong, vigorous, and healthy in all we do.
Benefits
At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.
About This Opportunity:
As a Sr. Product Compliance Specialist - Payment Integrity, you'll support Payment Integrity and Payment Operations as the primary compliance lead for regulatory requirements impacting claims, billing, reimbursement, and payment activities. You'll provide risk-based compliance oversight for areas including the No Surprises Act (NSA), Fraud, Waste & Abuse (FWA), regulatory change management, operational initiatives, and other payment-related processes.
You'll partner closely with Product, Operations, and Corporate Compliance teams to support policy governance, compliance training, issue intake management, and ongoing efforts to ensure compliance with applicable state and federal regulations.
Things You'll Do Here:
- Serve as the primary compliance liaison for Payment Integrity and Payment Operations, providing strategic guidance on regulatory and operational compliance matters.
- Interpret, analyze, and operationalize applicable regulatory requirements, including the No Surprises Act (NSA), Fraud, Waste & Abuse (FWA) laws, CMS requirements, and state Department of Insurance (DOI) regulations impacting payment and billing practices.
- Provide compliance oversight and guidance related to payment workflows, reimbursement methodologies, claims administration processes, and product development initiatives.
- Partner cross-functionally with operational leaders to identify, assess, and mitigate financial and regulatory compliance risks associated with payment and claims functions.
- Monitor and evaluate emerging regulatory developments, enforcement trends, and industry guidance to determine operational impact and support implementation of required changes.
- Support the development, review, implementation, and maintenance of financial and payment-related policies, procedures, and standard operating procedures (SOPs).
- Participate in high-risk initiatives, system implementations, process enhancements, and product changes to ensure compliance considerations are appropriately addressed.
- Assist with incident response activities involving payment disputes, FWA-related escalations, regulatory inquiries, and other compliance-related matters.
- Support internal audits, external audits, client audits, and regulatory examinations by coordinating documentation, responding to inquiries, and ensuring audit readiness.
- Collaborate with Corporate Compliance and cross-functional stakeholders on issue intake, triage, investigation support, tracking, corrective action planning, and resolution activities.
- Develop and deliver training, education, and compliance guidance to internal stakeholders regarding applicable regulatory requirements, policies, and operational expectations.
- Maintain accurate and organized documentation supporting compliance oversight activities, monitoring efforts, investigations, and audit preparedness.
What You'll Bring to the Team:
- Bachelor's degree required; concentration in Healthcare Administration, Finance, Business Administration, or a related field preferred.
- 5+ years of progressive experience in healthcare compliance, payment integrity, regulatory compliance, or related healthcare operations.
- Certified Professional Coder (CPC) credential or equivalent coding certification.
- Demonstrated knowledge and experience with claims processing operations and/or payment integrity programs.
- Demonstrated knowledge of healthcare billing, coding, and reimbursement regulations.
- Demonstrated experience with Fraud, Waste & Abuse (FWA) compliance frameworks and investigative processes
A plus if you have...
- Experience supporting No Surprises Act (NSA) implementation, oversight, and compliance activities.
- Experience within Payment Integrity, health plan, payer-side, or managed care operations.
- Familiarity with CMS programs, regulatory requirements, and enforcement priorities impacting claims and payment oversight.
- Experience operating within a Business Associate environment and supporting HIPAA-related compliance obligations.
- Professional certifications such as Certified in Healthcare Compliance (CHC), Certified Fraud Examiner (CFE), CPC, or other relevant healthcare compliance credentials.
Where You'll Work: This is a fully remote position, and we'll provide all the necessary equipment!
- Work Environment: You'll need a quiet workspace that is free from distractions.
- Technology: Reliable internet connection-if you can use streaming services, you're good to go!
- Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
- Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.
Why You'll Love Working Here
Valenz is proud to be recognized by Inc. 5000 as one of America's fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare.With this commitment, you'll find an engaged culture - one that stands strong, vigorous, and healthy in all we do.
Benefits
- Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
- Spending account options: HSA, FSA, and DCFSA
- 401K with company match and immediate vesting
- Flexible working environment
- Generous Paid Time Off to include vacation, sick leave, and paid holidays
- Employee Assistance Program that includes professional counseling, referrals, and additional services
- Paid maternity and paternity leave
- Pet insurance
- Employee discounts on phone plans, car rentals and computers
- Community giveback opportunities, including paid time off for philanthropic endeavors
At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.