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Director, Payment Integrity at Blue Cross Blue Shield Association - ApplyBlast

Director, Payment Integrity

Blue Cross Blue Shield Association

4 months ago

Chicago, IL

Hybrid

Full Time

Director

0 applicants

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About this role

The Director of Payment Integrity leads BlueCross Blue Shield Alliance's enterprise-wide strategy to enhance affordability and competitive capabilities across Commercial, Government, and National Accounts. This executive role drives the operationalization of payment integrity initiatives, manages programs with over $100M P&L impact, and partners with diverse stakeholders to establish robust controls and fraud detection systems.

Responsibilities

Lead enterprise payment integrity strategy across all business lines
Operationalize BlueCard payment integrity programs and claims processing
Manage multi-stakeholder initiatives with P&L impact exceeding $100M annually
Develop strategic roadmaps for National Accounts and Government Markets
Drive vendor selection and performance management for integrity services

Skills

Qualifications

BS in Business AdministrationMS in Healthcare AdministrationMBA in Business AnalyticsCISSPCMS Compliance Certification

About Blue Cross Blue Shield Association

bcbs.com

Headquarters

Chicago, Illinois, United States

Company Size

1001-5000 employees

Founded

1910

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Blue Cross Blue Shield Association is the national federation of independent, community-based Blue Cross and Blue Shield companies in the United States. It supports member plans through national programs, policy leadership, brand stewardship, health initiatives, and solutions that help expand access to healthcare coverage and services. The organization operates in the health insurance and healthcare administration industry.