• Account Service Manager Senior - Carelon…

    Elevance Health (Walnut Creek, CA)
    …to recover, eliminate and prevent unnecessary medical-expense spending._ **Account Service Manager Senior - Carelon Payment Integrity Commercialization** ... is granted as required by law._ The **Account Service Manager Senior - Carelon Payment Integrity Commercialization** is responsible for providing highly… more
    Elevance Health (08/29/25)
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  • Health Plan Operations, Payment

    Molina Healthcare (Dallas, TX)
    **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly ... on identifying, leading, and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy....years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
    Molina Healthcare (08/14/25)
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  • Payment Integrity Program…

    Molina Healthcare (San Diego, CA)
    …expertise and responsibility for oversight, production, and resolution of Health Plan Payment Integrity (PI) recovery concepts. This role executes and monitors ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
    Molina Healthcare (08/08/25)
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  • Payment Integrity Subrogation…

    Molina Healthcare (Everett, WA)
    **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace ... lines of business. This includes direct management of internal teams and external vendors handling both first-pass and second-pass recovery efforts. The role requires experience across a wide range of subrogation case types-including automobile-related claims… more
    Molina Healthcare (07/23/25)
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  • Carelon Medical Coding/Auditing Manager

    Elevance Health (Hanover, MD)
    **Carelon Medical Coding/Auditing Manager - Behavioral Health** **Supports Payment Integrity & Behavioral Health** **Location: Must be located in Maryland.** ... an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of...to improve the delivery of care. The **Medical** **Coding/Auditing** ** Manager ** is responsible for ensuring the accuracy of claims… more
    Elevance Health (08/29/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Sterling Heights, MI)
    …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
    Molina Healthcare (08/20/25)
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  • Lead Analyst, Configuration Oversight…

    Molina Healthcare (Provo, UT)
    …are seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and ... acumen. Experience in Medicaid managed care is required, and a background in payment integrity -either at a health plan or vendor-is strongly preferred.… more
    Molina Healthcare (07/24/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Woburn, MA)
    **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... an accommodation is granted as required by law._ **Carelon Payment Integrity ** is a proud member of...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (08/16/25)
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  • Application Architect Senior - Payment

    Elevance Health (Indianapolis, IN)
    **Application Architect Senior - Payment Integrity ** The **Application Architect Senior** creates architectural solutions that articulate the business context, ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
    Elevance Health (08/26/25)
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  • Consumer Payment Product Manager

    Regions Bank (Birmingham, AL)
    …and Access + Proven ability of leading and influencing cross functional teams **Consumer Payment Product Manager ** The Consumer Payment Product Manager ... are focused on results, dedicated to quality, strength and integrity , and possess the drive to succeed, then we...of the system. **Job Description:** At Regions, the Product Manager assists in the development, execution, and tracking of… more
    Regions Bank (07/13/25)
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