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Added 2 hours ago
Cybersecurity Internship (Remote) – Summer 2027 (Undergraduate)
Molina Talent Acquisition
United States
Added 13 hours ago
Field Care Manager, LTSS (LVN) - LOCAL TRAVEL REQUIRED
Molina Talent Acquisition
Arlington, TX · Mansfield, TX · Grand Prairie, TX
Added 13 hours ago
Field Care Manager, LTSS (RN) - Local Travel Required
Molina Talent Acquisition
Arlington, TX · Grand Prairie, TX · Mansfield, TX
Added 13 hours ago
Field Care Manager, LTSS (RN) - LOCAL TRAVEL REQUIRED
Molina Talent Acquisition
El Paso, TX
Added 13 hours ago
Field Care Manager, LTSS (RN) - LOCAL TRAVEL REQUIRED
Molina Talent Acquisition
Lancaster, TX · Duncanville, TX · DeSoto, TX · Red Oak, TX
Added 14 hours ago
Care Manager
Molina Talent Acquisition
Deerfield Beach, FL · Parkland, FL · Coconut Creek, FL · Plantation, FL · Fort Lauderdale, FL · Pembroke Pines, FL
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Care Manager (BH Licensed)
Molina Talent Acquisition
Palm Coast, FL · Bunnell, FL
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Care Manager (BH Licensed)
Molina Talent Acquisition
St Petersburg, FL · Palm Harbor, FL
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Care Manager (BH Licensed)
Molina Talent Acquisition
Tampa, FL · Lakeland, FL
Added 16 hours ago
Care Manager (BH Licensed) (Miami, FL)
Molina Talent Acquisition
Miami, FL
Added 16 hours ago
Care Manager (Miami, FL)
Molina Talent Acquisition
Miami, FL
Added 16 hours ago
Care Manager (RN) (Miami, FL)
Molina Talent Acquisition
Miami, FL
Added 17 hours ago
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Molina Talent Acquisition
Champaign, IL · Danville, IL
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Molina Talent Acquisition
Kissimmee, FL
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Molina Talent Acquisition
Orlando, FL
Added 17 hours ago
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Molina Talent Acquisition
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Care Manager (RN)
Molina Talent Acquisition
Labelle, FL · Clewiston, FL
Added 21 hours ago
Peer Specialist (Certified) North FL/Panhandle
Molina Talent Acquisition
Tallahassee, FL · Pensacola, FL · Ferry Pass, FL · Pace, FL · Navarre, FL · Panama City, FL · Crestview, FL
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Molina Talent Acquisition
Peoria, IL
Added 22 hours ago
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Molina Talent Acquisition
United States
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Molina Talent Acquisition
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Added 23 hours ago
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Molina Talent Acquisition
United States
Added 1 day ago
Supervisor, Long-Term Services & Supports (LTSS) - Milwaukee County, WI
Molina Talent Acquisition
Wauwatosa, WI
Added 1 day ago
Supervisor, Long-Term Services & Supports (LTSS) - Milwaukee County, WI
Molina Talent Acquisition
Wauwatosa, WI
Added 1 day ago
Medical Director, Behavioral Health (PST)
Molina Talent Acquisition
United States

Molina Talent Acquisition

Manager, Payment Integrity - REMOTE

United States

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Job details

Experience: At least 1 year management/leadership experience.
Posting language: English
Posted: Oct 22, 2026

Original job description

JOB DESCRIPTION Job Summary Leads and manages team responsible for payment integrity activities including recovery operations. Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and production targets.

Essential Job Duties

Leads and manages day-to-day operations for assigned payment integrity programs, ensuring accuracy, timeliness, and adherence to policies and procedures.
Hires, trains, and develops staff responsible for inventory management, reporting, data integrity, and recovery performance.
Implements and monitors quality assurance programs and performance metrics to ensure recovery and cost avoidance targets are met.
Collaborates with internal departments (Shared Services) to resolve system or process issues impacting payment accuracy.
Reviews and refines workflows and standard operating procedures to improve efficiency, accuracy, and audit readiness.
Facilitates meetings with vendors and internal partners to discuss production performance, operational barriers, and process optimization opportunities.
Analyzes operational data to identify trends, evaluate recovery effectiveness, and propose actionable improvements.
Supports compliance with CMS and state regulations.
Contributes to small- to mid-scale projects focused on process improvement, automation, and data accuracy.
Promotes a culture of accountability, continuous improvement, and professional development within the team.

Required Qualifications

At least 7 years of experience supporting health care operations, including 4 years payment integrity/claims experience, or equivalent combination of relevant education and experience.
At least 1 year management/leadership experience.
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
Strong verbal and written communication skills.
Microsoft Office suite and applicable software program(s) proficiency.

Preferred Qualifications

Managed care payor experience, preferably with Medicare/Medicaid government-sponsored programs.
Understanding of ICD-9/10CM, MS-, AP- and APR-DRG reimbursement.
Electronic medical record (EMR) and medical record repository experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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More about this job

Skills

Inventory management
Reporting
Quality assurance
Regulatory compliance
CMS
Process improvement
Leadership
Time management
Communication skills
Microsoft Office
EMR

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