The payment integrity vendor landscape has expanded rapidly, with plans now juggling specialist partners across pre-pay, post-pay, DRG validation, COB, FWA, clinical review, and an ever-growing list of AI-enabled point solutions. While each vendor promises incremental savings, the cumulative cost of sourcing, contracting, onboarding, integrating, and reconciling reporting across a sprawling stack is becoming a payment integrity problem in its own right. This panel brings together PI leaders who have wrestled with rationalising their vendor ecosystems to share practical approaches for building a leaner, better-orchestrated, and easier-to-manage vendor stack without losing savings yield.
- How to evaluate and source new vendors efficiently, including which proof points and pilot structures actually predict in-production performance
- Designing a waterfall and integration model that minimises duplicate findings, claim leakage, and operational drag across multiple vendors
- Consolidating vendor reporting and KPIs into a single view so PI leaders can defend total program value to senior leadership
Alejandro Rincon
Alejandro Rincon is an Associate Partner in ZS's Health Plan and Provider practice. He has over a decade of experience solving complex challenges across strategy, analytics, and AI. His work focuses on health plan payment integrity, operating model transformation, and data-driven decision making.
Tom Martin
Eliot Balistreri
Eliot Balistreri is a healthcare payment integrity leader with experience building and optimizing vendor and partner programs across the claims lifecycle. His work includes vendor evaluation and strategy, performance management, implementation, and financial planning & analysis.
Jason May
Jason May is Director of Payment Integrity Strategy & Operations at HCSC, where he leads the organization's payment integrity strategy, operational performance, and PI initiatives. His experience spans payment integrity analytics, vendor management, and the development and insourcing of payment integrity capabilities.
Jeff Baker
Kim Hoang
Kim Hoang is a payment integrity leader with over ten years of experience developing and operating health plan payment integrity programs. Drawing on her experience leading payment integrity functions at Molina Healthcare and advising health plans on strategic initiatives, she brings a practical perspective on vendor management, payment accuracy, and operational transformation.
