Senior Manager, Payment Integrity and Provider Escalation
Devoted Health · United States · US
Utilization Review
Remote
Dentist
Demand82
Career growth75
Healthcare fit60
Remote potential55
Salary band
USD 111k – 150k
5-year outlook
Likely a solid senior payer-operations leadership role with stable demand as Medicare Advantage payment integrity and audit scrutiny grow; compensation should reflect senior management and specialized coding/CMS expertise, though exact figures are not provided.
Clinical license
Not required
Applicant reach
narrow
Seniority
senior
Employment type
full-time
Date found
2026-10-19
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Dentist
- Rate period
- Annual
Why this was classified this way
- Contract
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying if you already have payer payment integrity, claims audit, coding, utilization review, or provider dispute leadership experience. Clinicians without that operational/coding background will likely find it a stretch.
Who should apply
Nurses, doctors, pharmacists, or allied health professionals with utilization review, clinical documentation improvement, coding/audit, payer appeals, Medicare Advantage compliance, or payment integrity operations experience and prior people management.
CV angle
Frame real clinical experience around clinical documentation review, coding literacy, payer appeals/utilization management, audit and compliance work, provider communication, root-cause analysis, SLA/queue management, and team leadership. Emphasize any Medicare Advantage, CMS, CPT/HCPCS/ICD-10, NCCI, LCD/NCD, or claims dispute exposure without overstating credentials.
Skills to highlight
- Payment integrity and provider dispute management
- Medicare Advantage CMS regulations and audit readiness
- CPT/HCPCS/ICD-10/NCCI/LCD/NCD coding knowledge
- Root-cause and claims trend analysis
- SLA, queue, and quality assurance operations
- People management and cross-functional leadership
- Provider education and escalation resolution
- AI/automation and process modernization
Role summary
A senior payer operations leadership role overseeing payment integrity disputes and appeals teams, managing provider escalations, analyzing claims and coding trends, ensuring CMS/audit compliance, and improving payment integrity processes.
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