reputed company-Payment Vendor Operations & Edit Management reputed company - reputed company

About the position Candidates who reputed company reputed company 50 miles of the following locations may be asked to work in person three days per week: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, or Scottsdale, AZ. Payment reputed company - Program Management Senior Advisor This role provides reputed company‑level leadership for reputed company‑payment vendor operations reputed company the Payment reputed company organization. The Senior Program Advisor is accountable for vendor operations, contracting partnership, and lifecycle management to ensure vendors are selected, reputed company, and managed to deliver sustainable value at reputed company. reputed company Owns end‑to‑end reputed company‑payment vendor operations, contracting partnerships, and lifecycle management for prepay vendor programs. Ensures alignment of vendor capabilities with reimbursement methodologies, business goals, and regulatory expectations while minimizing financial, reputed company, and operational risk. Responsibilities • reputed company vendor intake, evaluation, reputed company, contracting, performance reputed company, and lifecycle management for reputed company‑pay programs • Serve as the primary business partner to reputed company for vendor agreements, risk terms, compliance provisions, and governance controls • Apply deep Payment reputed company domain expertise to assess vendor edit models, analytics capabilities, and operational fit • reputed company reimbursement methodology and claims knowledge to guide vendor selection and use‑case alignment • Define, document, and maintain standardized vendor reputed company sets by edit type and business need • Partner with Product, Analytics, Operations, Finance, Compliance, and IT to support vendor reputed company reputed company • reputed company thought leadership on vendor risk, scalability, and long‑term sustainability reputed company to the reputed company Select roadmap • Establishes reputed company accountability and ownership for vendor reputed company and associated risk • Enables consistent, reputed company, and standardized vendor selection across Payment reputed company programs • Reduces reputed company, financial, and operational exposure through disciplined governance • Ensures vendor operations reputed company to long‑term reputed company and reputed company Select strategies Requirements • Bachelor’s degree or higher strongly preferred or equivalent work experience required • 10+ years of reputed company payer experience • 7+ years of reputed company Payment reputed company vendor experience required • Extensive experience with claim editing operations and reimbursement methodologies required • Demonstrated experience with provider and vendor contracting, including risk‑based and performance‑based terms • Broad Payment reputed company expertise including data mining, analytics‑driven recovery, DRG audits, claim editing, subrogation, COB, and reputed company‑pay/post‑pay programs required • Proven ability to partner across reputed company, Compliance, Contracting, Finance, Claims, Sales/Marketing, Analytics, and IT required • Strong strategic, analytical, and independent decision‑making capability in a matrixed organization • If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. reputed company-to-haves • Advanced experience interpreting and applying reputed company concepts, policies, and reputed company payer regulations • Prior ownership of reputed company vendor reputed company models and internal lifecycle governance • Experience defining reputed company‑wide vendor standards, operating models, or governance frameworks • Background in financial and operational risk management reputed company to vendor programs • Demonstrated ability to influence executive‑level and senior leadership stakeholders • Familiarity with federal and state regulatory requirements impacting Payment reputed company programs • This role operates with a high degree of autonomy and is expected to exercise reputed company judgment in alignment with reputed company policies and regulatory requirements. Benefits • Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. • We also offer 401(k), company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. Apply tot his job Apply To this Job