Manage Payments Integrity & QA for Maven Clinic, focusing on payment accuracy policies and team management. Lead quality assurance audits and cross-functional collaborations to enhance operations.
Responsibilities
Develop and implement comprehensive payment accuracy QA policies, procedures, and tracking mechanisms to ensure a "gold standard" for payment integrity.
Oversee the execution of quality assurance audits on payment transactions, evolving the process from manual sampling to scalable and data-driven, risk-based auditing.
Act as the primary point of contact and subject matter expert for all external client audits; manage the end-to-end audit lifecycle, from initial data requests to the presentation of findings, ensuring Maven’s internal administrative excellence is clearly demonstrated.
Lead cross-functional discussions to categorize findings and conduct deep-dive root cause analyses, ensuring that errors are not just identified but structurally prevented.
Collaborate cross-functionally to implement corrective action plans and hold partners accountable to performance SLAs.
Serve as the business owner for payment integrity tools; partner with Product/Engineering to design application enhancements and automated fail-safes.
Recruit, onboard, and manage a team of Payments Integrity & QA analysts, fostering a culture of high attention to detail and continuous operational improvement.
Requirements
8+ years in payment/claims analysis or auditing, with a strong preference for healthcare payer or insurance backgrounds.
Proven track record of managing and coaching teams, with the ability to build influential relationships with executive leadership.
Extensive experience using data and analytics tools (e.g., Looker) to identify patterns and drive business judgment.
Significant experience "creating order from chaos" and building processes in a fast-paced, entrepreneurial environment.
Proficiency in Asana, Jira, and Looker to manage workflows and report on program health preferred.
Benefits
Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics.
Whole-self care through wellness partnerships
Hybrid work, in office meals, and work together days
16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+)
Annual professional development stipend and access to a personal career coach through Maven for Mavens
401K matching for US-based employees, with immediate vesting
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