From Manual Muscle Memory to Modern Payment Integrity: A Conversation with Dana Ryan, Senior Manager Client Success

The Truth About Modernizing Payment Integrity Operations: Q&A with Dana Ryan

Amanda Bair: You’ve spent your entire career in payment integrity, starting at AIM Healthcare. What brought you into this industry—and what’s kept you here? 

Dana Ryan: Like a lot of people, I kind of fell into it. I was young—early twenties—and looking for something different. I interviewed at AIM Healthcare as a client service associate and ended up supporting clients in the Northeast. What’s funny is that some of those clients have come full circle and are clients again today.

What’s kept me here is a mix of familiarity and people. Many of the folks I worked with early on are still in this space. But more than anything, client service is my passion. I like being an advocate. I like helping people solve problems. That’s just who I am.

AB: After more than 20 years in the industry, what has stayed the same in payment integrity work? 

DR: The fundamentals are still the fundamentals. The focus is still on cost containment through claims accuracy validation, utilization review, and fraud, waste, and abuse mitigation. That hasn’t changed.

What has surprised me is how much manual work still exists. Even with all the advances in technology and automation, there are still plans holding tightly to old, manual processes. That part genuinely shocks me.

AB: Why do you think those manual processes are so hard to let go of? 

DR: It comes down to fear and control. Manual processes feel safe because people understand them. You know exactly where something went wrong. With automation, there’s anxiety: what if it fails, what if it’s buggy, what if the learning curve is too steep?

I see this even with clients who adopt new platforms. They want to replace their system, but not their processes. And that’s where things break down. If you buy a new system, you have to upgrade your processes to match it. That’s what successful clients do.

AB: What has changed the most since you entered the industry? 

DR: Technology, without a doubt. When I started, vendors submitted audit findings in spreadsheets. Health plans had teams reviewing them manually. Checking paid date lag, recovery windows, even debating who “found” an issue first.

What’s really changed is where the work happens. Early on, accuracy depended almost entirely on human review. Now, with platforms like Pareo®, much of that validation is handled by logic, which fundamentally changes how teams scale, prioritize, and operate.

We’re also seeing a major shift from post-pay to prepay strategies. And of course, AI is starting to play a larger role in payment integrity operations.

AB: Clients consistently say they love working with you and your team. What do you think is behind that? 

DR: Relationships—and trust. I tell my team all the time: clients want the truth. They might not always like it, but honesty builds credibility and accountability. They don’t want dates fudged or answers that just sound good. They want someone who is transparent and authentic.

That authenticity matters. If clients trust you, they’ll work through challenges with you.

We’re not perfect. But every CSM on my team is a true advocate for their clients. To put it in plain terms, their “give a damn” is pretty high. And in client success, that actually matters.

AB: How do you think about communication and client success as a discipline?

DR: I always say: Our job is 50% relationships, 50% troubleshooting and problem-solving—but 100% of it is communication.

That means being proactive, transparent, and empathetic. Technology can be frustrating. Deadlines are real. Stakes are high. We have to understand where clients are coming from.

It also means not being afraid to ask “why.” Clients often come with a problem and a proposed solution. But our job is to unpack that. When you ask “why?”—and sometimes “why?” and “why?” again—you get to the root issue. And often, there’s a better, faster, or more efficient way to solve it.

AB: How do you define success for a payment integrity team using Pareo?

DR: Success is using Pareo for what it’s capable of. Not just as an audit repository or reporting tool. The most successful clients leverage the insights, the automation, and the functionality to its fullest. They’re identifying cost savings and recoveries more easily. They understand error rates and payment accuracy. They’re creating real processing efficiencies.

Having a Pareo champion is critical here. Someone who truly embraces the system and asks, “What aren’t we using? What more can we do?” If you’re paying for a platform, you should be getting every ounce of ROI from it.

The most innovative teams don’t leave that role to chance. They intentionally designate and support a Pareo champion who owns platform expertise and continuous improvement.

AB: What gaps do you see most often in health plan payment integrity operations?

DR: Resistance to change. Many plans cling to outdated systems and processes because they’re familiar. A big part of my team’s job is helping clients unlearn that muscle memory and move toward more automated, logic-driven workflows.

The most successful leaders come to us asking, “What are we missing?” or “What are other plans doing?” That curiosity makes all the difference.

AB: What’s one thing payment integrity leaders could do right now to get more value from their programs?

DR: Attend POP Conference! It’s one of the best environments for collaboration I’ve seen. Health plan leaders connect over shared pain points, exchange ideas, and learn what’s actually working elsewhere.

POP accelerates program maturity. Teams come back with concrete ideas, peer validation, and a clearer sense of what ‘good’ actually looks like in modern payment integrity operations.

After POP, you can feel the excitement carry into client calls for weeks. People come back energized, curious, and ready to try new things. That kind of energy drives real change.

Conclusion

Dana’s career has spanned the full arc of payment integrity’s modernization: from spreadsheets and manual reviews, to automation and AI-driven insights. But the throughline in her experience isn’t technology alone.

It’s the belief that transformation only works when people are supported through it. For Dana, client success is about building trust, asking better questions, and helping teams unlearn what no longer serves them.

In an industry defined by complexity and constant change, her approach is a reminder that lasting operational progress happens at the intersection of modern systems, honest communication, and leaders who genuinely care whether the change sticks.