Manager, Payments Integrity & QA
About The Position
Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Maven's award-winning digital programs provide clinical, emotional, and financial support all in one platform, spanning fertility & family building, maternity & newborn care, parenting & pediatrics, and menopause & midlife. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs. Recognized for innovation and industry leadership, Maven has been named to the Time 100 Most Influential Companies, CNBC Disruptor 50, Fast Company Most Innovative Companies, and FORTUNE Best Places to Work. Founded in 2014 by CEO Kate Ryder, Maven has raised more than $425 million in funding from top healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. To learn more about Maven, visit us at mavenclinic.com. An award-winning culture working towards an important mission – Maven Clinic is a recipient of over 30 workplace and innovation awards, including: Fortune Change the World (2024) CNBC Disruptor 50 List (2022, 2023, 2024) Fortune Best Workplaces for Millennials (2024) Fortune Best Workplaces in Health Care (2024) TIME 100 Most Influential Companies (2023) Fast Company Most Innovative Companies (2020, 2023) Built In Best Places to Work (2023) Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024) Great Place to Work certified (2020, 2021, 2022, 2023, 2024) Fast Company Best Workplaces for Innovators (2022) Built In LGBTQIA+ Advocacy Award (2022) Maven is seeking a Manager, Payments Integrity & QA to lead and scale our payment operations quality framework. Reporting to the Senior Manager, Configuration & QA, you will move beyond audit execution to architect a robust and scalable, end-to-end payment integrity program. You will be responsible for building a high-performing team of Payments Integrity & QA analysts, developing internal audit protocols and accountability standards to maintain high-integrity payment operations, and partnering with Product/Engineering to automate fail-safes that ensure payment accuracy at scale.
Requirements
- 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.
- This role requires active work authorization in the US.
Nice To Haves
- Proficiency in Asana, Jira, and Looker to manage workflows and report on program health preferred.
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.
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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
