Director, Payment Integrity
L.A. Care Health PlanLos Angeles, California, United States
Posted January 15, 2026
135136 - 216218 USD year
Full Time
About the Company
L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents.
Job Description
The Director, Payment Integrity defines the payment integrity operating model and is responsible for prevention, governance, analytics, risk reduction, and sustained accuracy across all prepay and post-pay activity.
Requirements
- At least 7 years of deep experience in Payment Integrity, Fraud/Waste/Abuse prevention, Claims Accuracy, Medical Cost Containment, and/or other Program Integrity functions.
- At least 5 years of experience leading, supervising and/or managing staff.
- Demonstrated experience in pre-pay and/or post-pay program oversight, cost-avoidance strategies, recovery operations, clinical editing, or data mining.
Benefits
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
