• Lead and optimize the execution of enterprise payment integrity initiatives, with accountability for performance across prepay and postpay claims review programs. • Translate organizational strategy into operational action plans, ensuring alignment with savings goals, audit integrity, and regulatory compliance. • Partner with analytics, finance, compliance, and tech to identify new audit opportunities, improve processes, and develop scalable solutions. • Oversee the health of audit pipelines by ensuring work inflow and outflow are properly forecasted, balanced, and executed. • Monitor program KPIs such as savings, throughput, adjustment timeliness, and audit yield. • Take corrective action when performance falls short. • Use data to identify root causes of inefficiencies or payment errors and lead the development of solutions to reduce future risk. • Serve as a senior escalation point for complex issues involving claims adjustments, provider disputes, and operational bottlenecks. • Collaborate with departments such as Claims, Appeals, Provider Relations, and Medical Management to troubleshoot issues and implement improvements across the payment life cycle.