Deliver high-quality work on time
Oversee workflow planning, prioritization, and quality assurance for audit-support findings, data-driven insights, and reporting outputs.
Make sure outputs are accurate, consistent, and actionable, and that the team meets agreed service levels and operational commitments.
Drive measurable value for clients by supporting the identification of improper payments across.
Own the operational budget
Manage, and deliver against annual and ongoing budgets, including capacity forecasting, headcount planning, and monitoring of operational spend.
Make and recommend tradeoffs on staffing, throughput expectations, tooling, and workflow optimization, and report budget performance clearly to leadership.
Balance cost efficiency with scalable, high-quality delivery.
Improve how the work gets done
Run the team with strong metrics discipline, clear accountability, and consistent operating rhythms.
Continuously improve operational processes, including where automation and AI-assisted tooling can raise throughput and accuracy.
Partner with analytics, data engineering, reporting, product, and client-facing operations to resolve dependencies and surface needs and risks early.
Communicate with executive presence
Proactively report performance, risks, and delivery status to senior leadership and client-aligned stakeholders.
Translate operational realities into clear, concise summaries for upper management, and contribute to operational planning discussions.
Ability to meet with clients to understand needed product enhancements or other client needs.
What experience you bring (Role Requirements)
8+ years of experience in healthcare payment integrity, claims analytics, audit operations, or a similar delivery function, including 2+ years leading teams.
Demonstrated success managing budgets, headcount planning, and operational forecasting in a fast-paced, service-oriented environment.
Track record of scaling and maturing an execution-oriented team and managing performance through metrics and quality standards.
Strong communication and executive presence, with the ability to build trust across teams, manage competing priorities, and deliver results through others.
Comfort partnering with technical teams and interpreting analytical outputs.
Strongly preferred
Familiarity with healthcare claims data, audit processes, payment integrity concepts, and data mining approaches.
Experience in vendor-client delivery models.
Experience with AI tools.
Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/
