The Evolution of Upstream PI: A Step Closer to Faster, Smarter, Real-Time Decision Making | Kisaco Research

Payment integrity is evolving from a downstream claims audit function to a proactive, critical lever for upstream cost avoidance. Payment integrity leaders note that ‘shifting left’ can cut administrative duties by at least 10-15%, in addition to improving provider abrasion. But evolving to cost avoidance not only requires a shift in mindset, but an evolution in how data, AI tools, and cross-functional collaboration are used to enable proactive decision making.

  • Case studies: Critical strategies for launching pre-pay programs and measuring ROI
  • How AI is expanding pre-pay capabilities and required governance
  • Rethinking the impact and attribution of provider education initiatives

In partnership with Optum

Speaker(s): 
Moderator

Author:

Stephanie Jackson

Senior Vice President, Payment Integrity
Optum

Stephanie Jackson is Senior Vice President of Payment Integrity at Optum, where she leads strategy and growth across solutions that help health plans improve payment accuracy, reduce costs, and strengthen compliance across the claims lifecycle. She partners closely with payer organizations to deliver scalable, technology-enabled capabilities that drive operational efficiency, mitigate risk, and improve financial performance. Stephanie brings more than a decade of leadership experience at Optum, with a strong background spanning payer solutions, business development, and enterprise strategy. Stephanie holds a Bachelor of Science in Marketing and a Master of Business Administration from St. Cloud State University.

Stephanie Jackson

Senior Vice President, Payment Integrity
Optum

Stephanie Jackson is Senior Vice President of Payment Integrity at Optum, where she leads strategy and growth across solutions that help health plans improve payment accuracy, reduce costs, and strengthen compliance across the claims lifecycle. She partners closely with payer organizations to deliver scalable, technology-enabled capabilities that drive operational efficiency, mitigate risk, and improve financial performance. Stephanie brings more than a decade of leadership experience at Optum, with a strong background spanning payer solutions, business development, and enterprise strategy. Stephanie holds a Bachelor of Science in Marketing and a Master of Business Administration from St. Cloud State University.

Panelists

Author:

David Kagan

Chief of Healthcare Delivery
LA Care

David Kagan

Chief of Healthcare Delivery
LA Care

Author:

Linde Wilton

Senior Director of Operations
Provider Partners Health Plan

Linde Wilton

Senior Director of Operations
Provider Partners Health Plan

Author:

Philip David

Manager, Program Integrity Unit
Sentara

Philip David

Manager, Program Integrity Unit
Sentara
Time: 
12:15pm
Agenda Track No.: 
Track 2
Session Type: 
Panel
Force Inline Description: 
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