Director, Financial Operations – Payment Integrity Operations

Elevance Health

. Coordinate, direct, and manage key operational functions supporting Payment Integrity Operations .

Posted 10/12/2026full-timeUnited StatesLead💰 $138,320 - $238,602 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Payment Integrity Operations, operational excellence, and data-driven decision-making. Proven ability to lead cross-functional teams, manage complex projects, and ensure compliance with regulations while optimizing performance and inventory management.

Highest-signal resume keywords

Payment Integrity ExperienceOperational ExcellenceData AnalysisLeadership in Healthcare OperationsLean Six Sigma Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Financial ReportingBudgetingAudit GuidelinesInventory ManagementOperational WorkflowsPerformance Data AnalysisProcess ImprovementProject ManagementCompliance ManagementMulti-State Operations

Soft Skills

Executive-Level CommunicationCoaching and MentoringCross-Functional CollaborationProblem SolvingStrategic Thinking

Tools & Technologies

Reporting ToolsInventory Analytics SoftwarePerformance Management SystemsAutomation ToolsQuality Management Systems

Certifications & Qualifications

Lean Six Sigma Certification

Industry Keywords

Healthcare OperationsPayment IntegrityClaims OperationsEnterprise-Level ProjectsVendor Management

About the role

Key responsibilities & impact

Coordinate, direct, and manage key operational functions supporting Payment Integrity Operations
Provide leadership across operational, analytical, project, and technical areas
Use data and business insights to drive operational and process excellence
Improve workforce and inventory effectiveness and support strategic priorities
Serve as liaison between upstream and downstream business partners
Oversee departmental initiatives, inventory management, and operational reporting
Partner with Payment Integrity Strategy, Product, and Digital teams
Counsel senior management on enterprise-wide policies, strategies, performance, risks, business impacts, remediation plans, and go-forward strategies
Represent the company in legal matters and testify as needed
Develop and implement department vision, strategies, and tactics while minimizing costs
Ensure appropriate internal controls and compliance with government regulations
Develop policies and procedures
Work across operations, data, technology, and business areas to solve complex operational problems
Identify root causes, improve processes, and support enterprise initiatives
Hire, train, coach, counsel, and evaluate direct reports
Coordinate priorities, milestones, deliverables, risks, and cross-functional dependencies
Lead inventory management and reporting on inventory health, workload, productivity, performance trends, and operational risks

Requirements

What you’ll need

Minimum of 8 years of experience with operations, financial reporting and analysis, audit guidelines, budgeting, and multi-state operations and processes
Minimum of 5 years of management experience
Education and experience combination providing an equivalent background may be accepted
Payment Integrity experience and strong understanding of claims operations, operational workflows, and Payment Integrity work preferred
Strong data and analytical fluency preferred
Experience using reporting, inventory analytics, and performance data preferred
Operational and process excellence experience preferred
Experience leading in a complex healthcare operations environment preferred
Experience leading or partnering across workforce management, project support, reporting and analytics, technology, automation, and quality functions preferred
Strong executive-level written and verbal communication skills preferred
Experience across multiple healthcare lines of business, another health plan or Blue plan, or a Payment Integrity vendor environment preferred
Experience supporting enterprise-level projects and/or managing operational vendor relationships preferred
Knowledge and application of Lean Six Sigma or comparable continuous improvement principles preferred
Ability to work in-office 3 days per week
Must reside within a reasonable commuting distance from a posting location unless an accommodation is granted
Ideal candidates are located in Eastern or Central Time Zones or willing to work Eastern or Central Time Zone business hours

Benefits

Comp & perks

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution and match
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Hybrid work flexibility
Professional and personal growth opportunities