• The Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. • The Director leverages technology and the clinical and coding expertise of their associates to identify potential overpayments to be substantiated via review of medical records. • The Director contributes to the investigations of fraud, waste and abuse. • The Director requires an in-depth understanding of how organizational capabilities interrelate across the function or segment. • The Clinical and Coding Medical Record Review Director of Payment Integrity contributes to overall cost reduction, by increasing the accuracy of provider payments in our payer systems, and by ensuring correct claims payment. • The Director oversees internal teams and stacked vendor operations conducting reviews of inpatient and outpatient services using automation, new innovative technology and expertise. • The Director will make decisions related to the implementation of new/updated programs or large-scale projects. • The Director will lead Operations for technical procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance.