Program Manager, Health Plan Payment Integrity (Claims & Recovery)

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Program Manager, Health Plan Payment Integrity (Claims & Recovery) based in the United States.

This is an opportunity for an experienced healthcare professional to lead payment integrity initiatives that improve claims accuracy, strengthen cost management, and support regulatory compliance across health plan operations. In this role, you will oversee recovery programs, manage key performance action items, and drive projects focused on pre-payment edits, post-payment analysis, and overpayment recovery. You will work closely with claims, finance, compliance, network, and operational teams to identify issues and deliver effective solutions. Combining managed care expertise with strong analytical and business judgment, you will translate complex challenges into actionable strategies and measurable results. This is a full-time remote position in a highly regulated, cross-functional environment.