Quality Manager - Payment Integrity (Medical Coding Certification Required)

Use your strengths at Wellmark as a Quality Manager for Payment Integrity!   In this newly created and high-impact role, you’ll take the lead in designing and executing a robust audit process for both clinical and non-clinical work performed by the Payment Integrity team. Your responsibilities will include auditing incoming and outgoing invoices, managing ASO customer audits, and developing clear, scalable desk-level procedures and documentation that support operational excellence.You’ll also play a pivotal role in delivering quality review reports and surfacing trends that inform strategic decisions across the Payment Integrity function. Your insights will directly influence process improvements and help shape the future of quality assurance within the team.While this is not a people-leader role, it requires strong leadership qualities and confidence in your coding experience. You’ll need to build trust and credibility across teams, coach peers on best practices, provide direct peer-to-peer feedback, and influence others to uphold high quality standards. Collaboration is essential—you’ll work closely with partners in Compliance, Audit, Operations, Network Relations, and beyond to ensure alignment and drive results.