[Remote] Manager, Payments Integrity & QA
Note: The job is a remote job and is open to candidates in USA. Maven Clinic is the world's largest virtual clinic for women and families, dedicated to making healthcare accessible for all. They are seeking a Manager, Payments Integrity & QA to lead the payment operations quality framework, build a high-performing team, and ensure the integrity of payment processes through comprehensive QA policies and audits.
Responsibilities
• Develop and implement comprehensive payment accuracy QA policies, procedures, and tracking mechanisms to ensure a "gold standard" for payment integrity
• Oversee the execution of quality assurance audits on payment transactions, evolving the process from manual sampling to scalable and data-driven, risk-based auditing
• Act as the primary point of contact and subject matter expert for all external client audits; manage the end-to-end audit lifecycle, from initial data requests to the presentation of findings, ensuring Maven’s internal administrative excellence is clearly demonstrated
• Lead cross-functional discussions to categorize findings and conduct deep-dive root cause analyses, ensuring that errors are not just identified but structurally prevented
• Collaborate cross-functionally to implement corrective action plans and hold partners accountable to performance SLAs
• Serve as the business owner for payment integrity tools; partner with Product/Engineering to design application enhancements and automated fail-safes
• Recruit, onboard, and manage a team of Payments Integrity & QA analysts, fostering a culture of high attention to detail and continuous operational improvement
Skills
• 8+ years in payment/claims analysis or auditing, with a strong preference for healthcare payer or insurance backgrounds
• Proven track record of managing and coaching teams, with the ability to build influential relationships with executive leadership
• Extensive experience using data and analytics tools (e.g., Looker) to identify patterns and drive business judgment
• Significant experience 'creating order from chaos' and building processes in a fast-paced, entrepreneurial environment
• Proficiency in Asana, Jira, and Looker to manage workflows and report on program health preferred
Benefits
• Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics.
• Whole-self care through wellness partnerships
• Hybrid work, in office meals, and work together days
• 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+)
• Annual professional development stipend and access to a personal career coach through Maven for Mavens
• 401K matching for US-based employees, with immediate vesting
Company Overview
• Maven is a digital health platform that works with health plans and employers to offer virtual services for women’s and family health. It was founded in 2014, and is headquartered in New York, New York, USA, with a workforce of 201-500 employees. Its website is http://www.mavenclinic.com.
Company H1B Sponsorship
• Maven Clinic has a track record of offering H1B sponsorships, with 5 in 2025, 5 in 2024, 8 in 2023, 2 in 2022. Please note that this does not guarantee sponsorship for this specific role.
Apply Now
Apply Now
Responsibilities
• Develop and implement comprehensive payment accuracy QA policies, procedures, and tracking mechanisms to ensure a "gold standard" for payment integrity
• Oversee the execution of quality assurance audits on payment transactions, evolving the process from manual sampling to scalable and data-driven, risk-based auditing
• Act as the primary point of contact and subject matter expert for all external client audits; manage the end-to-end audit lifecycle, from initial data requests to the presentation of findings, ensuring Maven’s internal administrative excellence is clearly demonstrated
• Lead cross-functional discussions to categorize findings and conduct deep-dive root cause analyses, ensuring that errors are not just identified but structurally prevented
• Collaborate cross-functionally to implement corrective action plans and hold partners accountable to performance SLAs
• Serve as the business owner for payment integrity tools; partner with Product/Engineering to design application enhancements and automated fail-safes
• Recruit, onboard, and manage a team of Payments Integrity & QA analysts, fostering a culture of high attention to detail and continuous operational improvement
Skills
• 8+ years in payment/claims analysis or auditing, with a strong preference for healthcare payer or insurance backgrounds
• Proven track record of managing and coaching teams, with the ability to build influential relationships with executive leadership
• Extensive experience using data and analytics tools (e.g., Looker) to identify patterns and drive business judgment
• Significant experience 'creating order from chaos' and building processes in a fast-paced, entrepreneurial environment
• Proficiency in Asana, Jira, and Looker to manage workflows and report on program health preferred
Benefits
• Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics.
• Whole-self care through wellness partnerships
• Hybrid work, in office meals, and work together days
• 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+)
• Annual professional development stipend and access to a personal career coach through Maven for Mavens
• 401K matching for US-based employees, with immediate vesting
Company Overview
• Maven is a digital health platform that works with health plans and employers to offer virtual services for women’s and family health. It was founded in 2014, and is headquartered in New York, New York, USA, with a workforce of 201-500 employees. Its website is http://www.mavenclinic.com.
Company H1B Sponsorship
• Maven Clinic has a track record of offering H1B sponsorships, with 5 in 2025, 5 in 2024, 8 in 2023, 2 in 2022. Please note that this does not guarantee sponsorship for this specific role.
Apply Now
Apply Now