Manager Payment Integrity - #1409760

This job was posted by https://www.kansasworks.com : For more

information, please see: https://www.kansasworks.com/jobs/13280169

Blue Cross and Blue Shield of Kansas is looking to add to our

Affordability team and has a new opportunity for a Manager, Payment

Integrity. This position leads a team responsible for overseeing the

daily operations that ensure accurate and compliant claims

reimbursement. This includes validating billing and coding practices,

member eligibility, and adherence to contractual and regulatory

parameters. As a key enterprise subject matter expert (SME), the Manager

will ensure all processes are efficient, compliant, and aligned with

industry standards. The role requires strong leadership, strategic

oversight of operational performance, and collaboration across multiple

internal and external stakeholders.

This position is eligible to work remotely (8 or less days a month

onsite) or hybrid (9 or more days a month onsite) in accordance with our

Telecommuting Policy. Applicants must reside in Kansas or Missouri or be

willing to relocate as a condition of employment.

• Why Join Us?**
• **Family** **Comes First**: Total rewards package that promotes the
  
  

idea of family first for all employees; including paid time off and

family first leave.

• **Professional Growth Opportunities:** Advance your career with
  
  

ongoing training and development programs both through our internal

Blue University and external opportunities.

• **Make a Positive Impact:** Your work will directly contribute to
  
  

the health and well-being of Kansans.

• **Stability:** 80 years of commitment, compassion, and community
• **Lead and Inspire:** Guide and mentor your team to achieve their
  
  

full potential and success.

**What youll do**

• Lead a team responsible for enterprise Payment Integrity operations,
  
  

serving as the subject matter expert (SME) and guiding best

practices across workflows and processes.

• Provide direct leadership, coaching, and performance management to a
  
  

team focused on claims accuracy, billing integrity, and operational

compliance.Ensure payment integrity functions comply with federal

and state regulations, contractual, and operational standards.

• Lead projects and implementations, focusing on scalable internal
  
  

solutions and vendor engagements.

• Utilize business intelligence and data analytics to monitor
  
  

operations and identify cross-functional improvement opportunities.

• Maintain and enhance payment integrity productivity, aligning
  
  

operations with financial and quality targets.

• Develop, implement, and maintain payment integrity policies and
  
  

standard operating procedures (SOPs) to ensure consistency and

compliance.

• Collaborate with stakeholders across the enterprise to foster trust
  
  

and effective working relationships.