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Manager, Payment Integrity
Manager, Payment IntegrityINTEGRIS Health • Oklahoma City, OK, US
Manager, Payment Integrity

Manager, Payment Integrity

INTEGRIS Health • Oklahoma City, OK, US
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Overview

The Manager of Payment Integrity leads strategic oversight of underpayment recovery, reimbursement analysis, vendor performance, and financial evaluation of payer contract compliance. This role combines operational leadership with deep financial analytical capabilities to drive revenue recovery, optimize payer performance, and ensure compliance with contractual agreements.

Reporting to the Director of Revenue Integrity, this leader also supervises a team of analysts and collaborates closely with Revenue Cycle, Payer Strategy, Managed Care, and Finance to support enterprise financial goals.

Responsibilities

  • Underpayments Management

Lead identification, investigation, and resolution of underpayments across all payer types.

  • Develop and implement strategies to recover revenue lost due to contract underperformance, billing errors, or payer issues.
  • Coordinate with Managed Care on escalations and systemic payer performance issues.
  • Reimbursement Contract Analysis

    • Conduct in-depth analysis of payer reimbursement contracts and rate structures.

  • Ensure payment compliance with negotiated terms and flag anomalies, trends, or risks.
  • Support internal contract modeling, rate impact forecasting, and payment methodology assessments.
  • Financial Analysis & Reporting

    • Analyze financial trends, payment variances, and payer behavior; provide actionable insight to leadership.

  • Perform cost-benefit analyses and assist with the development of financial proformas and strategic planning scenarios.
  • Prepare and present dashboards, KPIs, and ad-hoc financial reports to senior management.
  • Vendor & Stakeholder Management

    • Oversee relationships with third-party underpayment recovery vendors; manage performance, reporting, and ROI evaluation.

  • Monitor contract compliance with external partners and recommend changes based on performance metrics.
  • Leadership & Team Management

    • Lead and mentor a team of Payment Integrity Analysts.

  • Ensure accurate reporting, timely follow-up, and consistent use of payment variance tools.
  • Provide education and training on payment methodologies and contract language interpretation.
  • Collaboration & Integration

    • Partner with Revenue Cycle, Compliance, Payer Strategy, Finance, and payer partners to align goals and resolve payer-related issues.

  • Facilitate cross-functional initiatives to enhance payment accuracy and reduce revenue leakage.
  • Contribute to enterprise-wide initiatives on payer strategy and payment reform readiness.

    • Qualifications

  • Experience :

    • Minimum 5 years of experience in healthcare finance, payment integrity, managed care analytics, or contract evaluation.

  • Strong understanding of payer reimbursement methodologies and healthcare finance operations.
  • Experience managing staff and / or external vendor relationships preferred.
  • Skills & Competencies :

    • Advanced proficiency in Excel and financial analysis tools.

  • Excellent communication, negotiation, and presentation skills.
  • Ability to interpret legal and financial language in payer contracts.
  • Strategic mindset with the ability to manage detail-oriented operations.
  • Preferred :

    • Knowledge of Epic, contract modeling software, or claims adjudication systems. Familiarity with Medicare / Medicaid payment methodologies.

  • Bachelor's degree in Healthcare Administration, Business, Accounting, Finance, or related field or Master's degree preferred.
  • CPA preferred.
  • Working Conditions :

    • Office-based with occasional travel to hospital and vendor sites.

  • Must be able to meet deadlines with limited resources in a dynamic environment.
  • Regular interaction with executive leadership and external partners.

    • J-18808-Ljbffr

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    Manager Payment Integrity • Oklahoma City, OK, US

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