Third Party Liability (TPL) Lead in United States Embassy at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Third Party Liability (TPL) Lead based in the United States.

This role offers the opportunity to lead critical Medicaid Third Party Liability operations and improve processes that support healthcare program integrity.
The Third Party Liability (TPL) Lead will oversee initiatives focused on cost avoidance, recovery, compliance, and operational efficiency within a complex healthcare environment.
The position plays a key role in ensuring Medicaid programs effectively coordinate benefits and recover eligible costs from responsible third parties.
Working with multidisciplinary teams, vendors, and stakeholders, the role drives process improvements and supports high-impact program initiatives.
The successful candidate will combine Medicaid expertise, project leadership, and analytical skills to enhance operational performance.
This opportunity is ideal for a healthcare professional passionate about improving systems, compliance, and outcomes for public health programs.

The Third Party Liability (TPL) Lead will oversee TPL operations, guide process improvements, and provide strategic support to ensure effective coordination of benefits, recovery activities, and program integrity initiatives.

• Lead Third Party Liability operations, including cost avoidance, recovery activities, lien-related processes, vendor coordination, reporting, and quality assurance.
• Oversee 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.

The ideal candidate will have strong experience in Medicaid operations, Third Party Liability programs, healthcare consulting, or related program integrity functions, with the ability to lead complex initiatives and collaborate with diverse stakeholders.

• Minimum of three years of experience within the last five years in a comparable Medicaid, healthcare, TPL, program integrity, operations, leadership, or consulting role.
• Experience leading or supporting Medicaid Third Party Liability, recovery, cost avoidance, audit, compliance, policy, or related operational activities.
• 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.
• Ability to analyze claims data, eligibility information, third-party payer data, and operational performance metrics.
• 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 is preferred.
• Experience supporting state Medicaid agency TPL programs, including implementation, testing, reporting, training readiness, performance monitoring, or stabilization activities, is a plus.
• Ability to travel up to 25% of the year as required.

• 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.
• Supportive workplace culture focused on inclusion, growth, and meaningful impact.
• Opportunities to work on projects that improve healthcare systems and community outcomes.