The Ideation Manager role provides direct people leadership for a team of Concept Ideation Analysts and is accountable for team performance, talent development, workload management, employee engagement, and delivery against business priorities. The role requires an experienced manager with strong knowledge of Payment Integrity, healthcare claims, and the concept development lifecycle. This leader ensures high-quality analysis, alignment across stakeholders and clients, and effective execution of priorities while strengthening business analysis practices and team capability. The role also champions process improvement, AI adoption, and automation opportunities that enhance efficiency, quality, and scalable ways of working.
Primary Responsibilities: - Lead and develop a team of Concept Ideation Analysts: Provide direct people leadership, including performance management, regular coaching, career development, talent planning, employee engagement, and recognition. Establish clear expectations and create an inclusive, accountable, and high-performing team culture.
- Build team capability: Assess current and future capability needs, identify skill gaps, develop growth plans, and create opportunities that strengthen Payment Integrity and business analysis expertise across the team.
- Apply Payment Integrity expertise: Use knowledge of healthcare claims, reimbursement, coding, policy, provider billing, and payment integrity methodologies to guide analysis, challenge assumptions, assess concept opportunities, and support accurate, actionable recommendations.
- Communicate with clarity and influence: Translate complex business needs, analysis findings, and strategic priorities into clear messages for leadership, client, and team members
- Set direction and priorities: Balance team capacity, prioritize work, and align resources to meet department objectives and evolving business needs
- Promote consistency, process improvement, and innovation: Establish and reinforce standard business practices, tools, and processes that improve quality, efficiency, and collaboration while reducing manual effort and modernizing how the team operates.
- Advance AI adoption and automation: Lead the evaluation and adoption of AI-enabled tools, automation opportunities, and more efficient ways of working that improve productivity, reduce rework, and support scalable delivery.
- Build client relationships and executive confidence: Develop trusted partnerships and present updates, recommendations, and team insights with confidence, professionalism, and strong executive presence.
Capabilities for Success - People Leadership: Demonstrates successful experience directly managing employees, setting expectations, providing differentiated performance feedback, developing talent, leading through change, and building an engaged and accountable team.
- Payment Integrity Acumen: Understands healthcare claims, provider billing, reimbursement methodologies, coding and policy considerations, and the processes used to identify, validate, prevent, or recover inappropriate payments.
- Communication Excellence: Communicates clearly and effectively across all levels, adapting messages for clients, leadership, peers, and team members.
- Strategic Prioritization: Balances competing priorities, aligns team efforts to business goals, and makes sound decisions in a dynamic environment.
- Business Analysis Rigor: Promotes analytical thinking, structured problem solving, and consistent delivery of high-quality outputs.
- Continuous Improvement, AI & Automation Mindset: Identifies opportunities to improve team processes, adopt AI-enabled solutions, and leverage automation to enhance efficiency, consistency, and effectiveness.
Required Qualifications: - 5+ years of experience in healthcare
- 3+ years within Payment Integrity, claims operations, healthcare analytics, or a closely related function
- 3+ years of direct people-management experience with accountability for employee performance, coaching, development, and engagement
- Demonstrated experience leading teams through organizational, process, or technology-enabled change
- Experience with medical claims, coding guidelines, reimbursement methodologies, provider data, and healthcare policy
- Experience using data and analysis to identify payment issues, validate opportunities, determine root causes, and support solution development
- Demonstrated experience working across highly collaborative, cross-functional environments and building strong partnerships with multiple stakeholder groups
- Experience establishing or improving team processes, standards, or operating practices
- Experience leading or supporting process improvement, AI adoption, automation, or technology-enabled transformation efforts
- Working knowledge of healthcare claims, provider billing, reimbursement, coding, policy, and payment accuracy concepts
- Proven ability to manage priorities, balance team workloads, and deliver results in a matrixed environment
Preferred Qualifications: - Experience leading multidisciplinary Payment Integrity teams
- Experience with prepayment and post-payment concept development
- Knowledge of the end-to-end concept development lifecycle
- Proven exposure to continuous improvement initiatives and emerging tools such as AI or automation solutions
