Third Party Liability (TPL) Lead

The Third Party Liability (TPL) Lead is needed for a position based in the United States. This role involves leading Medicaid TPL operations, process improvements, and supporting high-impact program initiatives.

Accountabilities

• Oversee TPL operations, including cost avoidance, recovery activities, lien-related processes, vendor coordination, reporting, and quality assurance.
• Guide subject matter experts by reviewing analyses, recommendations, documentation, operational support activities, and quality outcomes.
• Collaborate with program integrity and policy teams to align TPL initiatives with compliance, audit, policy, process, and system priorities.
• Provide guidance to stakeholders on Medicaid TPL requirements, operational best practices, regulatory expectations, and compliance considerations.
• Support daily TPL activities by coordinating with internal teams, vendors, health plans, legal partners, and other external stakeholders.
• Lead the development, tracking, and improvement of TPL lien-related processes and documentation.
• Facilitate meetings, manage action items, monitor decisions, identify risks, and support timely issue resolution.
• Review vendor files, policy updates, cost avoidance reports, recovery reports, and operational performance data.
• Analyze existing workflows and lead business process redesign efforts to improve efficiency, accountability, compliance, and recovery outcomes.
• Follow project management standards related to documentation, communication, reporting, data protection, and stakeholder engagement.
• Collaborate across technology, process improvement, training, change management, and strategic project teams to support successful program delivery.

Requirements

• Minimum of three years of experience within the last five years in a comparable Medicaid, healthcare, TPL, program integrity, operations, leadership, or consulting role.
• Strong understanding of Medicaid coordination of benefits, third-party payer data, recovery processes, lien-related activities, and payer-of-last-resort principles.
• Experience interpreting and applying federal and state Medicaid requirements.
• Ability to coordinate projects across multiple functions, including legal, finance, analytics, claims, eligibility, policy, audit, and vendor management teams.
• Strong project leadership, facilitation, communication, analytical, and stakeholder management skills.
• Experience supporting business process redesign within Medicaid, healthcare, claims, eligibility, or program integrity environments.
• Experience managing or coordinating the work of subject matter experts, analysts, or project team members.
• Familiarity with Medicaid eligibility systems, claims platforms, integrated eligibility systems, or vendor-managed healthcare data environments.
• Experience supporting state Medicaid agency TPL programs, including implementation, testing, reporting, training readiness, performance monitoring, or stabilization activities.
• Ability to travel up to 25% of the year as required.

Benefits

• Competitive salary range of $90,000 - $120,000 USD annually.
• Remote work flexibility.
• Opportunity to contribute to large-scale healthcare and Medicaid improvement initiatives.
• Comprehensive benefits supporting physical, mental, career, social, and financial wellbeing.
• Collaborative environment with cross-functional teams and experienced professionals.
• Career development and learning opportunities.
• Opportunities to work on projects that improve healthcare systems and community outcomes.