Overview

Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives. Learn even more about the work that drives us at personifyhealth.com.

Responsibilities

Ready to lead the team that makes sure every claim gets paid right? Why This Role Matters Every claim that moves through our TPA operation is a promise to an employer group and the members behind it, and Payment Integrity is where we keep that promise accurate. You’ll run the team that catches errors before they become costly, keeps work flowing on time, and protects the trust our clients place in us. The processes you shape and the standards you set directly affect payment accuracy, compliance, and how confident our employer groups feel in the numbers we hand them. When your team performs at a high level, our clients see it in their results, and our whole organization benefits from it. What You’ll Actually Do Lead and develop your team: Train, oversee, and supervise Payment Integrity team members so they have the skills and direction to deliver accurate, timely work every day. Run daily operations: Direct the day-to-day Payment Integrity workflow, keeping workloads balanced and the operation moving without bottlenecks. Own inventory control: Monitor claim inventory closely so nothing ages out or slips through, and keep processing outcomes on schedule. Assign priorities with purpose: Delegate tasks and set priorities so the most time-sensitive and highest-impact work gets handled first and handled right. Define and refine KPIs: Build and sharpen the productivity and quality measures that show how the team is performing and where to improve. Drive procedural updates: Keep procedures current as regulations, client needs, and workflows change, so the team always works from the right playbook. Partner with Account Management: Work alongside account management on employer group-facing metrics and processes, turning operational data into clear answers for clients. Champion process improvement: Spot inefficiencies and recurring errors, then put practical fixes in place that raise accuracy and speed.

Qualifications

What You Bring to Our Team Education & Experience: High School Diploma 10+ years of progressive experience in TPA administration Proven leadership experience in claims processing, operational oversight, inventory management, and process improvement Technical Skills: Claims processing NSA/IDR (No Surprises Act / Independent Dispute Resolution) TPA operations Compliance and policy adherence Analytical and critical thinking applied to claims and operational data KPI development and performance reporting

Benefits

The Highlights: Competitive base salary and benefits effective day one Comprehensive medical and dental through our own health solutions (yes, we use what we build) Unlimited PTO—rest and recharge time is non-negotiable Mental health support, retirement planning, and financial protection Professional development with clear career progression and learning budgets Mission-driven culture where diverse perspectives drive real impact on people's health Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks. Compensation: This position offers a base salary range of $80,000 - $95,000, depending on location, skills, and experience. You're eligible for our full benefits package starting day one. Our Commitment: Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing. Stay Safe: Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com. View all legitimate openings at personifyhealth.com/careers.