Lead Director, Network Cost Management Solutions and Payment Integrity

• Leads team of approximately 6 employees and overall scope of 25-30 to develop enterprise-wide solutions (medical cost containment and payment integrity) to address business problems, resulting in lower cost of care for clients and members enabling the organization to be competitive in the marketplace and effectively serve its customers
• Responsible for the out of network product portfolio, market analysis, creative and new solutions, pricing and profitability strategies, measures performance and ensures regulatory compliance to achieve business objectives and drive growth in the competitive TPA market
• Collaborates across the organization to optimize the achievement of strategic business objectives to include profitable growth and improved organizational effectiveness

• Minimum 8 years in healthcare industry experience in product, finance, operations, network/out of network, payment integrity, and/or related disciplines
• Proven leadership/management experience
• Market exposure to account management, sales, brokers, and clients
• Proven ability to analyze and interpret complex data sets to develop actionable strategies
• Strong communication skills, including experience presenting to senior leadership
• Strong analytical abilities with proficiency in data interpretation and financial modeling
• Ability to influence and drive change within a complex organizational structure
• Growth mindset, creative solutions, problem solver, quick decision maker
• Self-motivator, works well independently
• Strong leadership, collaboration and teamwork

Bachelor's degree preferred/specialized training/relevant professional qualification

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility