Assistant Director – Payment Integrity Policy, Implementation

Cambia Health Solutions

. Develop strategy and oversee reimbursement and coding policy activities .

Posted 9/16/2026full-timeSalt Lake City • Idaho • United StatesLead💰 $101,444 - $186,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in reimbursement policy development, coding methodologies, and payment integrity strategies, with a strong focus on operational management and stakeholder collaboration in healthcare settings.

Highest-signal resume keywords

Reimbursement Policy DevelopmentCoding MethodologiesPayment Integrity StrategiesHealthcare EconomicsProject Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Policy DevelopmentCoding ReviewOperational ManagementFinancial JustificationData Infrastructure ManagementBudget DevelopmentChange ManagementKPI DevelopmentRegulatory ComplianceTrend Management

Soft Skills

Verbal CommunicationWritten CommunicationTeam LeadershipAnalytical SkillsCollaboration

Tools & Technologies

AI ToolsHealthcare InformaticsRFP Process Tools

Certifications & Qualifications

Relevant Licensure/Certifications

Industry Keywords

Managed CareHealthcare DeliveryProvider ContractingHealthcare PolicyHealthcare Dynamics

About the role

Key responsibilities & impact

Develop strategy and oversee reimbursement and coding policy activities
Drive operationalization of internal and vendor Payment Integrity opportunities
Lead correct coding and reimbursement reviews and methodologies
Assess and develop policies
Lead the Reimbursement Policy Committee
Consult on system-wide implementation of payment policies
Establish an ongoing ideation and Payment Integrity initiative development team
Act as a key stakeholder in trend management
Direct the coding disputes team
Optimize payment edits and rules across internal and vendor-supported applications
Lead strategic planning and execution of reimbursement policy, coding disputes, and Payment Integrity ideation initiatives
Track programs, develop financial justifications, and prioritize initiatives with Healthcare and Clinical Services leadership, legal, and healthcare informatics
Develop budgets, policies, workflows, and change management plans
Monitor results and metrics to ensure strategic goals, deliverables, and regulatory compliance
Oversee enterprise stakeholder vetting of proposed reimbursement policies
Direct innovation teams and coding dispute resolution
Develop and execute affordability initiatives across tools and levers
Provide strategic viewpoints and long-term roadmaps for reimbursement policy and Payment Integrity strategies
Consult on legislative and regulatory issues
Maintain program governance, accountability, deliverables, risks, dependencies, and escalations
Direct data infrastructure systems, enhancements, and upgrades
Evaluate IT infrastructure business needs
Develop team KPIs and metrics
Collaborate in the RFP process
Provide direction to teams and foster a positive team experience
Supervise 3–6 direct FTEs and 40–60 total FTEs

Requirements

What you’ll need

Masters (or higher) degree in a health-related field required
Minimum of seven years of management or professional business experience in a managed health care system, medical group, hospital, or related health care delivery business, or equivalent combination of education and experience
Strong policy, coding, and operational understanding
Knowledge of health care economics and financing, health care industry dynamics, and provider contracting strategies, techniques, and processes
Success managing professional business relationships in a managed care system, medical group, hospital, or related health care delivery business
Excellent verbal and written communication skills
Strong business analytical skills and abilities
Strong project management and coordination ability
Ability to function effectively as a management team member
Experience with AI tools and technologies highly desired
Relevant licensure/certifications and performance history may affect hiring range
Background check required
Must have wired internet with minimum 5 Mb upload and 10 Mb download speeds for work-from-home option
Must have access to a personal mobile device for MFA

Benefits

Comp & perks

Competitive salary
Medical, dental and vision coverage for employees and eligible family members, including mental health benefits
Annual employer contribution to a health savings account
Generous paid time off varying by role and tenure
10 company-paid holidays
Market-leading retirement plan including company match on employee 401(k) contributions
Potential discretionary retirement contribution based on company performance, with no vesting period
Up to 12 weeks of paid parental time off after 12 months of continuous service
Award-winning wellness programs that reward participation
Employee Assistance Fund
Commute and parking benefits
Work-from-home options for most roles
Employee resource groups
Cambia-supported community outreach programs
Bonus opportunities with a 15% bonus target
Wired internet connection required for work-from-home option
Personal mobile device access for Multi-Factor Authentication