Diagnosis-Related Group Manager

🕒 Setembro 9

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $100.000 - $120.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 16%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 64 dias.
• As vagas desta empresa costumam ser preenchidas em 28 dias.

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EXL

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🛡️ Seguros

📦 Logística

💰 $2.000.000 Venture Round em 2015-01

Healthcare • Insurance • Logistics

Escolher um parceiro digital vai além das capacidades — trata-se de colaboração e caráter.

Descrição

• Lead the planning, coordination, and execution of DRG audit activities • Support execution and ongoing improvement of DRG audit programs, including readmissions and place of service reviews • Partner with product, analytics, technology, and operations teams to implement audit solutions • Oversee day-to-day audit operations in alignment with SLAs, quality expectations, and productivity goals • Manage inventory, workflow distribution, aging, and throughput for timely audit completion • Directly supervise auditors through coaching, feedback, and performance management • Ensure adherence to productivity, quality, and turnaround standards • Monitor regulatory and payer guideline updates to keep audits compliant and current • Support one-on-ones, training, and development planning • Identify operational gaps and contribute to process improvement initiatives • Escalate and help resolve client or operational issues • Support reporting on productivity, quality, and inventory metrics • Assist with program implementations and operational initiatives • Oversee team performance, risks, client SLAs, and operational goals

🎯 Requisitos

• Bachelor's Degree • CCS, RHIT, RHIA preferred • 5–8 years of experience with MS-DRG and APR-DRG, including strong knowledge of ICD-10-CM/PCS and Official Coding Guidelines • Prior experience leading teams or acting in a supervisory capacity • Strong understanding of DRG reimbursement methodologies • Knowledge of Medicare, Medicaid, and commercial payer guidelines • Experience working in audit or payment integrity operations • Strong analytical skills with ability to identify trends and support decision-making • Effective communication and interpersonal skills • Proficiency in Microsoft Office and audit/reporting systems • Ability to manage audit workflows and team performance to meet operational targets • Strong understanding of quality, productivity, and audit accuracy standards • Ability to analyze data and identify trends and improvement opportunities • Effective collaboration across clinical, operational, and technical teams • Ability to support process improvements and workflow enhancements • Strong organizational and time management skills • Ability to build relationships and maintain positive team and client interactions • U.S.-based work location

🏖️ Benefícios

• Competitive benefits package, including healthcare, vision, dental, and 401(k) options • Fast-paced, innovative environment with a team of industry-leading experts • Hands-on experience with top-tier clients in the healthcare industry • Strong culture of collaboration, support, and inclusivity • Up to 10% annual travel for team meetings and limited client onsite engagements

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