Hiring: Director, Payment Integrity Strategy & Operations Company: Community Health Choice Location: Greater Houston Job Posted Time: 2026-09-12 14:11:28 Target Skills & Keywords : Medicare, Project Management About the job Experience: •10 years of experience in reimbursement policy, provider reimbursement, and/or strategic or product development •7 years leadership experience, leading people and/or complex cross-divisional projects or programs Required Skills: •JOB SPECIFICATIONS AND CORE COMPETENCIES •35% Operational Oversight & Performance Management •Manages day-to-day PI operations, ensuring execution of process improvements and program redesigns. •Oversees team performance, implements internal evaluations, and coordinates with vendors and solution partners. •Guides the development of new PI models and reimbursement engagement strategies •30% Strategic Leadership & Program Development •Develops and drives the overall strategy for Payment Integrity (PI), aligning cost of care initiatives with enterprise goals. •Sets SMART goals, leads ideation and vetting processes, and establishes Qualifications: •Work Experience (Years and Area): Must have direct health plan experience Previous experience directly with business case development, financial and market analysis and/or process redesign •Management Experience (Years and Area): 7 years leadership experience, leading people and/or complex cross-divisional projects or programs Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!