Director, Healthcare Payment Integrity

Are you ready to make an impact

West Monroe has an immediate opportunity for a Director aligned to the Healthcare Practice. This role will focus on delivering business and technology consulting solutions for payer organizations with a specialization in Payment Integrity claims operations reimbursement methodologies and healthcare finance transformation.

Working alongside leaders across our National Healthcare Practice this role will be responsible for developing and growing client relationships identifying and pursuing new business opportunities leading complex consulting engagements and delivering exceptional value to clients. Candidates should be passionate about healthcare transformation client service and working in a collaborative entrepreneurial environment.

• Develop and expand relationships with payer organizations including medical and ancillary insurers.

• Serve as a trusted advisor to client executives by bringing deep expertise in Payment Integrity claims processing reimbursement recovery and provider revenue cycle operations.

• Identify and originate opportunities within existing and prospective client accounts.

• Participate in business development activities including client meetings industry events networking and proposal development.

• Support the sales cycle by helping shape solutions work plans pricing approaches and value propositions.

• Leverage market insights and industry expertise to position West Monroe as a trusted advisor and thought leader.

• Collaborate with Healthcare Practice leadership Business Development and Marketing teams to support go-to-market activities and client growth initiatives.

• Contribute to account growth through cross-selling and expansion of existing client relationships.

• Serve as an engagement leader on Payment Integrity and payer transformation engagements.

• Manage all aspects of client delivery including scope budget staffing workstreams deliverables and overall engagement profitability.

• Provide strategic and operational guidance to clients on Payment Integrity programs claims operations reimbursement methodologies and recovery optimization.

• Communicate project status risks recommendations and outcomes to executive stakeholders.

• Ensure value creation is identified measured and articulated throughout the engagement lifecycle.

• Mentor and develop consulting teams while maintaining high standards of quality and client service.

• Act as a point of escalation for client concerns and drive issues through resolution.

• Apply deep industry expertise to solve complex client challenges and deliver measurable business outcomes.

• Contribute to the growth and evolution of West Monroes Healthcare Practice through knowledge sharing thought leadership and solution development.

• Develop Payment Integrity methodologies tools and best practices that enhance client delivery.

• Support recruiting onboarding and mentoring efforts across the practice.

• Actively participate in performance management and career development of team members.

• Foster a culture of collaboration inclusion innovation and continuous improvement.

• Contribute to thought leadership through industry participation conference speaking opportunities and market-facing content.

Qualifications

• Bachelors degree required; advanced degree preferred.

• 10 years of consulting healthcare payer or healthcare operations experience with significant exposure to Payment Integrity claims operations reimbursement and recovery programs.

• Demonstrated experience leading complex client engagements and managing executive-level stakeholder relationships.

• Proven ability to identify develop and support new business opportunities within existing and prospective accounts.

• Strong understanding of healthcare payer operations claims processing reimbursement methodologies provider payment models and Payment Integrity programs.

• Experience leading business and technology transformation initiatives within health insurance organizations.

• Strong program and project management experience including scope budget risk issue and stakeholder management.

• Excellent verbal written and executive presentation skills.

• Demonstrated ability to mentor and develop team members.

• Commitment to fostering an inclusive culture and embracing diverse perspectives.

Were a global business and technology consulting firm passionate about creating measurable value for our clients delivering real-world solutions.

The combination of business and technology is not new but how we bring them together is unique. Were fluent in both. We know that technology alone is not the answer but how we apply it is. We rely on data to constantly adapt and solve new challenges. Actions that work today with outcomes that generate value for years to come.

At West Monroe we zero in on the heart of the opportunity getting to results faster and preparing people for whats next.

Youll feel the difference in how we work. We show up personally. Were right there in the room with you co-creating through the challenges. With West Monroe collaboration isnt a lofty promise but a daily action. We work together with you to turn vision into clear action with lasting impact.

West Monroeis an Equal Employment Opportunity Employer
We believe in treating each employee and applicant for employment fairly and with dignity. We base our employment decisions on merit experience and potential without regard to race color national origin sex sexual orientation gender identity marital status age religion disability veteran status or any other characteristic prohibited by federal state or local law. To learn more about diversity equity and inclusion at West Monroe visit If you require a reasonable accommodation to participate in our recruiting process please inquire by sending an email to .

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