Medical Policy Release Manager

🕒 vor 1 Tag

🇺🇸 Vereinigte Staaten – Remote

💵 $105.000 - $125.000 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

🦅 H1B-Visum-Sponsor

Dieses Unternehmen hat in der Vergangenheit H1B-Visa gesponsert.

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Cotiviti

WebsiteLinkedInAlle Stellen

5001 - 10000 Mitarbeiter

🏥 Gesundheitswesen

💼 Beratung

📦 Logistik

Healthcare • Consulting • Logistics

Cotiviti ist ein Unternehmen für Gesundheitstechnologie und -analytik, das sich auf die Verbesserung der Zahlungsgenauigkeit und -leistung durch fortschrittliche Datenanalysen spezialisiert hat. Sie arbeiten mit Krankenkassen, Regierungsbehörden und Gesundheitsdienstleistern zusammen, um Einblicke zu liefern, die die Qualität und Effizienz der Gesundheitsversorgung verbessern. Mit Lösungen wie Risikoadjustierung, Zahlungsrichtlinienmanagement und Mitgliederengagement zielt Cotiviti darauf ab, die finanziellen und klinischen Ergebnisse im Gesundheitswesen zu optimieren.

Beschreibung

• 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

🎯 Anforderungen

• 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

🏖️ Vorteile

• 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