H-1B Visa Program Development Manager Jobs
Program Development Manager roles qualify for H-1B visa sponsorship as specialty occupations requiring a bachelor's degree or higher in fields like public administration, education, business, or a related discipline. Employers filing H-1B petitions for this role must certify a prevailing wage through the DOL before USCIS adjudicates the petition.
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Get Access To All JobsAbout Sagility
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Manager, Payment Integrity Program Development & Innovation
Job Description:
Manager, Payment Integrity Program Development & Innovation is responsible for leading a team of healthcare payment integrity experts focused on developing, implementing, and optimizing complex audit programs that identify and recover healthcare overpayments. This role oversees the creation of audit concepts, claim selection methodologies, and recovery strategies across inpatient, outpatient, professional, specialty, and durable medical equipment (DME) claim types.
The Manager serves as a key leader within the Payment Integrity organization, partnering with clinical, operational, analytics, appeals, and client-facing teams to drive innovative audit solutions, maximize recovery opportunities, and ensure program effectiveness. This position plays a critical role in expanding audit capabilities, improving financial outcomes, and delivering exceptional value to clients.
Essential Responsibilities
Leadership & Team Development
- Lead, mentor, and develop a team of Subject Matter Experts responsible for complex audit program design and implementation.
- Foster a culture of accountability, collaboration, innovation, and continuous improvement.
- Establish performance expectations and monitor team productivity, quality, and operational effectiveness.
- Support recruitment, onboarding, professional development, and succession planning initiatives.
Audit Program Development
- Develop and maintain a portfolio of complex payment integrity audit concepts and recovery initiatives.
- Identify emerging overpayment risks and reimbursement vulnerabilities across multiple healthcare claim types.
- Evaluate opportunities based on financial impact, operational feasibility, recovery potential, and client value.
- Collaborate with internal stakeholders to prioritize and implement new audit programs.
Claim Selection Strategy
- Partner with analytics and technology teams to design, validate, and optimize claim selection methodologies and audit algorithms.
- Define business requirements and selection criteria for complex audit programs.
- Monitor audit performance and continuously refine targeting strategies to improve recovery yield and audit accuracy.
- Evaluate program metrics, including hit rates, recovery rates, overturn rates, and return on investment.
Regulatory & Technical Expertise
- Provide subject matter expertise on healthcare reimbursement methodologies, payment policies, coding guidelines, and industry best practices.
- Ensure audit concepts and methodologies comply with applicable regulatory, contractual, and operational requirements.
- Serve as an escalation point for complex audit findings, provider disputes, and appeals support activities.
- Maintain current knowledge of Medicare, Medicaid, Commercial, and Managed Care reimbursement methodologies.
Client & Cross-Functional Collaboration
- Partner with Operations, Clinical, Appeals, Product, Analytics, Compliance, and Client Services teams to support successful program implementation.
- Participate in client-facing discussions related to audit methodologies, findings, performance metrics, and program strategy.
- Support sales, implementation, and proposal efforts by providing subject matter expertise and audit program recommendations.
- Contribute to strategic initiatives that enhance payment integrity capabilities and client outcomes.
Required Qualifications
Education
- Bachelor’s degree in Nursing, Health Information Management, Healthcare Administration, Business Administration, Finance, or a related field.
Experience
- Minimum of 5 years of healthcare Payment Integrity experience.
- Minimum of 3 years of leadership experience managing audit, coding, clinical, payment integrity, or SME teams.
- Demonstrated experience developing complex healthcare audit concepts and claim selection methodologies.
- Strong knowledge of healthcare reimbursement methodologies, claims adjudication, coding systems, and payment integrity operations.
- Experience collaborating with analytics, operations, and appeals teams to implement audit programs.
Preferred Qualifications
- Current unrestricted RN license.
- RHIA, RHIT, CCS, CPC, COC, CIC, CRC, or other applicable healthcare industry certification.
- Experience with Medicare, Medicaid, Commercial, and Medicare Advantage reimbursement methodologies.
- Experience supporting client implementations, provider engagement activities, and RFP responses.
- Experience with healthcare data analysis, audit technology platforms, and complex claims analytics.
Knowledge, Skills & Abilities
- Healthcare Reimbursement Methodologies
- Payment Integrity Program Management
- Complex Audit Concept Development
- Claims Analytics and Audit Selection Strategies
- Regulatory Compliance and Healthcare Policy Knowledge
- Leadership and Team Development
- Strategic Planning and Problem Solving
- Project and Portfolio Management
- Strong Written and Verbal Communication Skills
- Client Relationship Management
- Process Improvement and Operational Excellence
Success Measures
Success in this role will be measured by:
- Development and implementation of new audit concepts
- Recovery yield and financial performance of audit programs
- Improvement in audit hit rates and return on investment
- Team productivity, quality, and engagement
- Client satisfaction and retention
- Regulatory compliance and audit defensibility
- Innovation and continuous improvement outcomes
Sagility is an Equal Opportunity Employer/Vet/Disability
Location:
Work@Home USAUnited States of America
About Sagility
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Manager, Payment Integrity Program Development & Innovation
Job Description:
Manager, Payment Integrity Program Development & Innovation is responsible for leading a team of healthcare payment integrity experts focused on developing, implementing, and optimizing complex audit programs that identify and recover healthcare overpayments. This role oversees the creation of audit concepts, claim selection methodologies, and recovery strategies across inpatient, outpatient, professional, specialty, and durable medical equipment (DME) claim types.
The Manager serves as a key leader within the Payment Integrity organization, partnering with clinical, operational, analytics, appeals, and client-facing teams to drive innovative audit solutions, maximize recovery opportunities, and ensure program effectiveness. This position plays a critical role in expanding audit capabilities, improving financial outcomes, and delivering exceptional value to clients.
Essential Responsibilities
Leadership & Team Development
- Lead, mentor, and develop a team of Subject Matter Experts responsible for complex audit program design and implementation.
- Foster a culture of accountability, collaboration, innovation, and continuous improvement.
- Establish performance expectations and monitor team productivity, quality, and operational effectiveness.
- Support recruitment, onboarding, professional development, and succession planning initiatives.
Audit Program Development
- Develop and maintain a portfolio of complex payment integrity audit concepts and recovery initiatives.
- Identify emerging overpayment risks and reimbursement vulnerabilities across multiple healthcare claim types.
- Evaluate opportunities based on financial impact, operational feasibility, recovery potential, and client value.
- Collaborate with internal stakeholders to prioritize and implement new audit programs.
Claim Selection Strategy
- Partner with analytics and technology teams to design, validate, and optimize claim selection methodologies and audit algorithms.
- Define business requirements and selection criteria for complex audit programs.
- Monitor audit performance and continuously refine targeting strategies to improve recovery yield and audit accuracy.
- Evaluate program metrics, including hit rates, recovery rates, overturn rates, and return on investment.
Regulatory & Technical Expertise
- Provide subject matter expertise on healthcare reimbursement methodologies, payment policies, coding guidelines, and industry best practices.
- Ensure audit concepts and methodologies comply with applicable regulatory, contractual, and operational requirements.
- Serve as an escalation point for complex audit findings, provider disputes, and appeals support activities.
- Maintain current knowledge of Medicare, Medicaid, Commercial, and Managed Care reimbursement methodologies.
Client & Cross-Functional Collaboration
- Partner with Operations, Clinical, Appeals, Product, Analytics, Compliance, and Client Services teams to support successful program implementation.
- Participate in client-facing discussions related to audit methodologies, findings, performance metrics, and program strategy.
- Support sales, implementation, and proposal efforts by providing subject matter expertise and audit program recommendations.
- Contribute to strategic initiatives that enhance payment integrity capabilities and client outcomes.
Required Qualifications
Education
- Bachelor’s degree in Nursing, Health Information Management, Healthcare Administration, Business Administration, Finance, or a related field.
Experience
- Minimum of 5 years of healthcare Payment Integrity experience.
- Minimum of 3 years of leadership experience managing audit, coding, clinical, payment integrity, or SME teams.
- Demonstrated experience developing complex healthcare audit concepts and claim selection methodologies.
- Strong knowledge of healthcare reimbursement methodologies, claims adjudication, coding systems, and payment integrity operations.
- Experience collaborating with analytics, operations, and appeals teams to implement audit programs.
Preferred Qualifications
- Current unrestricted RN license.
- RHIA, RHIT, CCS, CPC, COC, CIC, CRC, or other applicable healthcare industry certification.
- Experience with Medicare, Medicaid, Commercial, and Medicare Advantage reimbursement methodologies.
- Experience supporting client implementations, provider engagement activities, and RFP responses.
- Experience with healthcare data analysis, audit technology platforms, and complex claims analytics.
Knowledge, Skills & Abilities
- Healthcare Reimbursement Methodologies
- Payment Integrity Program Management
- Complex Audit Concept Development
- Claims Analytics and Audit Selection Strategies
- Regulatory Compliance and Healthcare Policy Knowledge
- Leadership and Team Development
- Strategic Planning and Problem Solving
- Project and Portfolio Management
- Strong Written and Verbal Communication Skills
- Client Relationship Management
- Process Improvement and Operational Excellence
Success Measures
Success in this role will be measured by:
- Development and implementation of new audit concepts
- Recovery yield and financial performance of audit programs
- Improvement in audit hit rates and return on investment
- Team productivity, quality, and engagement
- Client satisfaction and retention
- Regulatory compliance and audit defensibility
- Innovation and continuous improvement outcomes
Sagility is an Equal Opportunity Employer/Vet/Disability
Location:
Work@Home USAUnited States of America
See all 989+ H-1B Visa Program Development Manager Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new H-1B Visa Program Development Manager Jobs.
Get Access To All JobsTips for Finding H-1B Visa Sponsorship as a Program Development Manager
Map your degree to the role
USCIS requires your degree field to relate directly to program development management. A business, public administration, or nonprofit management degree strengthens your petition. If your degree is in an unrelated field, document how your coursework maps to program planning and organizational management.
Check employer LCA filing history first
Search Migrate Mate to filter Program Development Manager roles by verified DOL Labor Condition Application filings. This confirms an employer has actually sponsored H-1B workers before, not just listed the role as open to visa holders.
Target cap-exempt institutions strategically
Universities, research nonprofits, and government-affiliated organizations are cap-exempt, meaning they can file your H-1B petition any time without waiting for the April lottery. Program Development Manager roles are common at these institutions, and cap-exempt filing removes lottery risk entirely.
Verify prevailing wage before salary negotiation
Look up your target metro area's wage level for this occupation using the OFLC Wage Search before entering salary discussions. Your employer's LCA must certify a wage at or above the DOL prevailing rate, so knowing the threshold protects you from underpaid offers that could trigger an RFE.
Clarify O*NET classification with your employer
Program Development Manager can map to multiple O*NET codes depending on the sector, which affects the prevailing wage tier DOL assigns. Confirm with your employer which job code they plan to use on the LCA before the petition is drafted to avoid wage discrepancies during adjudication.
Negotiate H-1B filing fee coverage in your offer
Federal law prohibits employers from passing USCIS filing fees to H-1B workers, but legal and preparation costs are not always covered by default. Get written confirmation in your offer letter that your employer covers all required government fees before signing.
H-1B Visa Program Development Manager: Frequently Asked Questions
Does a Program Development Manager role qualify as an H-1B specialty occupation?
Yes, provided the position requires at least a bachelor's degree in a specific field such as business administration, public administration, education, or organizational management. Roles where any general degree suffices can face USCIS scrutiny. Your employer's job description should explicitly state the degree requirement and its direct relevance to the program development responsibilities.
Which types of employers commonly sponsor H-1B visas for Program Development Manager positions?
Universities, health systems, large nonprofits, government contractors, and workforce development organizations are among the most active sponsors for this role. Many of these are cap-exempt institutions, which means they can file H-1B petitions year-round. Use Migrate Mate to browse Program Development Manager roles filtered by employers with confirmed H-1B filing history.
How does the H-1B lottery affect my chances as a Program Development Manager candidate?
If your employer is a private company subject to the cap, your petition enters the annual H-1B lottery, which selects roughly 85,000 registrations each fiscal year. Cap-exempt employers such as universities and qualifying nonprofits bypass the lottery entirely. Targeting cap-exempt organizations in the program development sector is one of the most reliable ways to avoid lottery uncertainty.
Can I switch from one Program Development Manager role to another while on H-1B?
Yes, but your new employer must file a new H-1B petition before your start date with them, or use H-1B portability under AC21 if your petition has been pending for 180 days or more. The new role must also qualify as a specialty occupation. A change in sector, such as moving from healthcare program management to workforce development, may require updated O*NET documentation.
What documentation strengthens an H-1B petition for a Program Development Manager?
A detailed job description that ties specific duties to a required degree field is critical. USCIS also reviews the employer's organizational chart, your academic transcripts, and any professional licenses or certifications. If your degree is from outside the U.S., a credential evaluation from a NACES-member agency that confirms equivalency to a U.S. bachelor's degree is required before USCIS will approve the petition.