MedReview Inc. · 1 day ago
Delivery Manager/Director - Payment Integrity
MedReview Inc. is seeking an experienced Delivery Manager/Director to oversee the successful execution of Payment Integrity initiatives. This role will provide leadership across cross-functional teams, ensuring timely delivery of solutions in areas such as DRG review and Hospital Bill Audit.
Health CareMedicalNon ProfitProfessional Services
Responsibilities
Lead the planning, execution, and delivery of PI projects and operational initiatives
Partner with Business Analysts to translate documented requirements (BRDs, FRDs, user stories) into actionable delivery plans
Coordinate across operations, IT, QA, and data teams to ensure alignment and accountability
Establish and track key performance metrics (savings, accuracy, timeliness, client satisfaction)
Manage project timelines, resource assignments, budgets, and risks, escalating issues proactively
Facilitate stakeholder communication through status reports, governance meetings, and executive updates
Drive continuous improvement in delivery processes, ensuring best practices in project management and PI operations
Ensure compliance with regulatory, contractual, and policy requirements impacting PI initiatives
Qualification
Required
Bachelor's degree in Business, Healthcare Administration, or related field
Master's degree a plus
3-5+ years in project/delivery management within healthcare, payer operations, or PI
Demonstrated success leading cross-functional teams delivering complex operational/technology solutions
Strong understanding of healthcare claims workflows and PI domains (DRG, HBA, COB, IBR, data mining, edit engines)
Expertise in project management methodologies (Agile, Waterfall, or hybrid)
Excellent leadership, organizational, and stakeholder management skills
Proficiency with project tracking tools (Jira, MS Project, Confluence, Smartsheet, etc.)
Strong problem-solving and decision-making skills under pressure
Preferred
Prior experience leading large PI programs (multi-million-dollar savings/recoveries)
Knowledge of regulatory frameworks (CMS guidelines, NCCI edits, LCD/NCD policies)
Experience working with payer SIU/FWA operations, subrogation, or provider audits
PMP, PgMP, or SAFe certification (or equivalent) preferred
Company
MedReview Inc.
MedReview is a different type of payment integrity company.
Funding
Current Stage
Growth StageRecent News
2025-11-20
2025-08-29
2025-07-23
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