Initiative Project Leader - Integrity Product

Initiative Project Leader
- Payment Integrity Product

This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office, with ideal candidates being able and willing to work Eastern or Central Time Zone business hours.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Initiative Project Leader
- Payment Integrity Product is responsible for analyzing, determining and driving opportunities to standardize, eliminate waste and improve end-to-end processes to transform Payment Integrity solutions that will enable value and improve member, end-user, and provider experience. This Leader will strengthen operating strategy, roadmap visibility, organizational communications, and alignment across Payment Integrity and its enterprise partners.

Primary duties may include, but are not limited to:
Serves as a thought leader regarding improvements to end-to-end processes with our providers, members, and internal end-users in mind. Connects critical dots across matrixed organizations and the broader Payment Integrity portfolio through integration points in Claims, Health Plans, Operations, PE&C, PSCCR, Finance, Actuary, Digital, and IT. Leads strategic initiatives from assessment through implementation and ensures business controls are in place to monitor the sustainability of process improvements.

Builds consensus across organizational functional areas, leads root cause analysis, uncovers trends, contributes to solution definition, and determines internal and external best practices. Creates greater visibility into organizational priorities, budgets, capacity plans, release schedules, risks, and dependencies to support leadership decision-making. Plans and manages the organization’s rhythm of business, including leadership reviews, State of the State meetings, all-hands meetings, newsletters, release notes, and follow-up actions.

Articulates strategic priorities, roadmap status, risks, decisions, and results through clear communications tailored to executive, operational, and technical audiences. Creates and maintain an end‑to‑end Payment Integrity roadmap that enables leadership to prioritize, rebalance resources, and keep shared organizations focused on the highest‑value work.

Requires a BA/BS degree in a related field and a minimum of 8 years of professional experience in an operations environment including 7 years of leading and directing large enterprise‑wide projects; or any combination of education and experience, which would provide an equivalent background.

Experience serving in a chief of staff, executive business partner, enterprise strategy, business operations, portfolio management, or transformation leadership capacity preferred. Exceptional executive communication and storytelling skills, including the ability to translate complex information into clear presentations, transformation updates, get to the “so what” and value proposition, release management, prioritization and leadership communications preferred. Experience developing and managing enterprise roadmaps, organizational priorities, capacity plans, budgets,…