Carve Out Lead

Job Title: Director, Payment Integrity Reports To: Vice President, Operations This is an exempt position reporting to the Vice President, Operations. The Director of Payment Integrity is responsible for the Quality Assurance, Grievances & Appeals, and Fraud, Waste & Abuse teams. This role functions as both the director setting strategy for these departments and the direct supervisor managing day to day operations. This position interfaces with all departments of SIHO as well as external stakeholders, vendors, and customers. The ability to interact with all levels of SIHO staff and external parties with a high level of professionalism, while adapting quickly between multiple high priority items, is essential. Brief Description of Duties: Directly supervise and manage the Quality Assurance, Grievances & Appeals, and Fraud, Waste & Abuse teams, including day to day oversight, staffing, and performance management Read, research, and interpret federal and state regulations governing grievances and appeals, and translate regulatory requirements into practical, actionable process changes Continuously monitor and improve grievances and appeals processes to ensure ongoing compliance with CMS and state regulatory requirements Support the claims and benefit configuration quality assurance program, including developing and delivering training and education for staff Stay current on emerging fraud, waste, and abuse trends and lead efforts to proactively identify and investigate potential FWA Review results across all three departments and identify process improvement initiatives and cost savings opportunities Analyze department and operational data in Excel to identify trends and draw actionable insights Manage data transfers with vendor partners, meet with vendors regularly to ensure processes are working as intended, and escalate potential issues as they arise Interact directly with customers as needed Work with SIHO Legal and key leadership on special cases and external inqu…

Veröffentlicht 26 Sept 2026

GiveWell’s mission is to help people in need as much as we can by researching the most cost‑effective ways to save and improve lives, sharing our work openly, and directing donations to the programs we believe will do the most good. Our work, which focuses on global health and well-being, is funded by tens of thousands of donors who rely on our research to inform their giving. We’ve grown from directing $1.5 million in 2010 to directing more than $400 million in 2025. We anticipate our total grantmaking is likely to approach or even exceed $1 billion this year, and we are working toward a future that could be several times that scale. Through years of deliberate groundwork, we’ve been growing our research capacity and scope in order to direct substantially more funding to the most impactful opportunities we can find. We’re hiring a Senior Communications Officer, Strategic Communications to lead GiveWell’s development of messaging and narratives that explain its work across different audiences and contexts. You will translate the organization’s increasingly diverse and complex work into clear, accurate communications and lead major initiatives that require close coordination across GiveWell. This role reports to Steven Profaizer, our Vice President of Communications, and will lead a small and growing team. This is one of three new communications leadership roles, alongside a Senior Communications Officer, Media & Public Affairs and a Senior Communications Officer, Editorial & Production. About the role Both our research and impact are expanding. Last year, we directed more than $400 million t Please mention the word **REVOLUTIONIZE** and tag RMTUxLjgwLjE0Ni43Mw== when applying to show you read the job post completely (#RMTUxLjgwLjE0Ni43Mw==). This is a beta feature to avoid spam applicants. Companies can search these words to find applicants that read this and see they're human.

Veröffentlicht 11 Sept 2026