Director Payment Integrity

The Director of Payment Integrity at SIHO Insurance Services is responsible for overseeing the Quality Assurance, Grievances & Appeals, and Fraud, Waste & Abuse teams. Daily tasks include managing staff performance, ensuring compliance with federal and state regulations, and improving processes related to grievances and appeals. The role requires proficiency in analyzing data using Excel to identify trends and insights, as well as the ability to interact professionally with various stakeholders, including customers and vendors. Candidates should be adept at adapting to multiple high-priority tasks and staying informed about emerging trends in fraud and abuse. While the advert does not specify required qualifications or experience, the position demands a strong understanding of regulatory requirements and operational management. This is a remote position, making it suitable for individuals who can work independently and communicate effectively across different levels of an organization. The role is ideal for someone with a strategic mindset and a focus on continuous improvement in operational processes.