Supervisor, Payment Integrity

HMSA
United States, Hawaii, Honolulu
818 Ke’eaumoku Street (Show on map)
April 08, 2024
Execute, monitor, and lead implementation of payment integrity strategy. Assess the success of payment integrity activities for continued alignment with organizational goals (e.g., Healthcare Cost Trend) and ensure expected results are being achieved. Communicating external teams' outcomes, data analysis, complex processes and action plans to internal teams. Provides vendor oversight to design, propose, implement and administer solutions that increase claims payment accuracy and integrity. Coordinate with Director of Payment Integrity for BCBSA Payment Integrity activities to include the following: Serve a primary point of contact with BCBSA. Acquire and maintain a strong understanding of BCBSA payment integrity requirements and ensure compliance. Proactively monitor and provide updates regarding status of activities and escalate issues to leadership. Oversee and manage staff for payment integrity activities. Hire, train and direct staff. Conduct performance reviews and mentor staff as needed in order to achieve expected results and/or professional development goals. Provides feedback and coaching (helping individuals to solve problems/issues on their own) Performs all other miscellaneous responsibilities and duties as assigned or directed.