Medical Policy Release Manager

🕒 Agosto 6

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $105.000 - $125.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Cotiviti

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

Cotiviti é uma empresa de tecnologia e análise em saúde que se especializa em melhorar a precisão e o desempenho dos pagamentos por meio de soluções avançadas de análise de dados. Eles se associam a planos de saúde, agências governamentais e provedores de serviços de saúde para fornecer insights que aprimoram a qualidade e a eficiência na prestação de cuidados. Com soluções como ajuste de risco, gerenciamento de políticas de pagamento e engajamento de membros, a Cotiviti busca otimizar os resultados financeiros e clínicos para o ecossistema de saúde.

Descrição

• Manage medical policy releases, release schedules, and IT system-related updates • Develop and maintain release calendars for medical policy updates and software patches • Coordinate dependencies across multiple teams • Ensure policy and technical releases comply with CMS, federal, state, and regulatory requirements • Liaise between Clinical Policy teams, IT, and Business Operations • Communicate release status, risks, and timelines • Lead go/no-go decisions and validate user acceptance testing • Establish rollback procedures for potential deployment failures • Coordinate tickets and communicate data-file status in release notes • Validate policy and code changes across content management systems • Manage risks and resolve issues affecting release scope, schedule, and quality • Plan and coordinate releases across development, QA, and production environments • Ensure risk assessment, prioritization, approval, and change documentation • Act as a gatekeeper for policy accuracy • Support client teams on PURs and other eLL inquiries • Participate in eLL application upgrades or functionality changes • Hire, develop, coach, lead, and retain team talent • Complete performance-plan responsibilities and special projects

🎯 Requisitos

• 6 years of coding experience in healthcare policy, billing and coding software, regulatory analysis, or IT release management • Degree and professional certification (AHIMA or AAPC) preferred • Familiarity with ITIL frameworks • Experience with change management tools such as Jira and ServiceNow • Experience planning, scheduling, and coordinating releases across development, QA, and production environments • Experience with risk assessment, prioritization, approvals, and change documentation • Ability to interpret rule descriptions, scripts, and temporary rules • Experience validating policy and code changes in content management systems • Strong analytical and comparison skills for multi-tab validation • Experience researching CPT, HCPCS, ICD, or NDC codes • Familiarity with claims payment and reimbursement methodologies • Ability to analyze data and make data-driven decisions • Ability to manage timelines and multiple projects with high accuracy and attention to detail • Strong analytical, critical-thinking, and problem-solving skills • Proficiency in Microsoft Office Suite • Preferred knowledge of Excel, pivot tables, and functions • Excellent interpersonal, verbal, and written communication skills • Work-at-home setup with high-speed internet • Flexibility to participate in conference calls across global time zones • Occasional after-hours and weekend work for major deadlines • Ability to provide a dedicated, secure work area • Ability to provide high-speed internet connectivity and maintain an office setup • Ability to perform duties with or without reasonable accommodation • Understanding of Cotiviti policies, procedures, information security, and regulatory compliance • Ability to maintain confidentiality and data security

🏖️ Benefícios

• Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance coverage • 401(k) savings plan • Paid family leave • 9 paid holidays per year • 17–27 days of Paid Time Off (PTO) per year, depending on specific level and length of service • High-speed internet and other tools will be provided • Equal employment opportunity