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Why this grade This listing scored 57/100, which is a C. It lost the most ground on pay transparency. See the breakdown
- Description depth 20 / 20 How much the posting actually says about the work, measured in characters of real text.
- Freshness 12 / 15 How recently it was posted. Older postings are likelier to be filled or abandoned.
- Pay transparency 12 / 25 A published salary range, worth more than any other single factor because it is what a candidate cannot find out without applying.
- Remote clarity 8 / 15 Whether "remote" means anywhere, or is quietly restricted to one country.
- Corroboration 5 / 10 Whether more than one source carries this listing.
- Role specificity 0 / 10 Whether the listing is tagged well enough to tell what the role actually is.
Every figure above is arithmetic over the posting itself — its salary field, its text, its age, its tags and how many sources carry it. How the grades work →
This listing does not state a salary
$100k – $148k
That is the middle half of what comparable roles paid on this board over the last 90 days — 60 listings that did publish a figure, median $124k. It is not this employer's offer, and we have no idea what they pay. It is only what the rest of the market advertised.
Leads and manages team responsible for payment integrity activities including recovery operations. Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and production targets.
Essential Job Duties
- Leads and manages day-to-day operations for assigned payment integrity programs, ensuring accuracy, timeliness, and adherence to policies and procedures.
• Hires, trains, and develops staff responsible for inventory management, reporting, data integrity, and recovery performance.
• Implements and monitors quality assurance programs and performance metrics to ensure recovery and cost avoidance targets are met.
• Collaborates with internal departments (Shared Services) to resolve system or process issues impacting payment accuracy.
• Reviews and refines workflows and standard operating procedures to improve efficiency, accuracy, and audit readiness.
• Facilitates meetings with vendors and internal partners to discuss production performance, operational barriers, and process optimization opportunities.
• Analyzes operational data to identify trends, evaluate recovery effectiveness, and propose actionable improvements.
• Supports compliance with CMS and state regulations.
• Contributes to small- to mid-scale projects focused on process improvement, automation, and data accuracy.
• Promotes a culture of accountability, continuous improvement, and professional development within the team.
Required Qualifications
- At least 7 years of experience supporting health care operations, including 4 years payment integrity/claims experience, or equivalent combination of relevant education and experience.
• At least 1 year management/leadership experience.
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong verbal and written communication skills.
• Microsoft Office suite and applicable software program(s) proficiency.
Preferred Qualifications
- Managed care payor experience, preferably with Medicare/Medicaid government-sponsored programs.
• Understanding of ICD-9/10CM, MS-, AP- and APR-DRG reimbursement.
• Electronic medical record (EMR) and medical record repository experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Originally posted on Himalayas
Apply for this role Opens himalayas.app — the link as listed; we have not yet verified it is the employer's own page
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Where this listing came from
- 09 Sep 2026 Himalayas first sighting
Seen on 1 board over 0 days.