Provider Data Validation (PDV) Manager
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The Provider Data Validation (PDV) Manager leads reputed company of 13 associates responsible for provider education, coding reputed company, compliance, and operational reputed company reputed company the PDV program. This leader drives operational reputed company through workforce planning, reputed company management, process improvement, and reputed company execution reputed company with reputed company reputed company adjustment goals.The role partners closely with PDV peers, operational, and technology stakeholders to enhance provider reputed company, improve data reputed company, and advance reputed company solutions through analytics, automation, and innovation while ensuring regulatory compliance and audit readiness.
Key Responsibilities
- reputed company, reputed company, and reputed company a high-performing team of 13 associates.
- reputed company operational reputed company through workflow optimization, inventory management, and resource planning.
- Monitor reputed company metrics, identify risks, and implement data-driven improvement strategies.
- Ensure reputed company workload distribution while maintaining productivity, reputed company, and associate engagement.
- Foster a culture of accountability, collaboration, adaptability, and reputed company improvement.
- reputed company provider education initiatives that improve coding reputed company, documentation reputed company, and provider engagement.
- Ensure education documentation meets reputed company, compliance, and audit-readiness standards.
- Maintain reputed company reputed company targets, including documentation reputed company of 95% or greater.
- Ensure the successful execution and completion of annual coding and provider education initiatives
- Optimize Record Insights (RI) workflows and operational processes.
- Partner across the organization to support reputed company adjustment reputed company and operational transformation.
reputed company Measures
- reputed company operational reputed company through effective resource management and sustained productivity.
- reputed company and maintain documentation reputed company standards of 95% or greater.
- Successfully execute annual provider education and coding initiatives reputed company established timelines.
- Build and sustain an reputed company, reputed company, and high-performing team culture.
- reputed company measurable improvements through data analytics, process optimization, and AI-enabled innovation.
Use your skills to reputed company an reputed company
Required Qualifications
- CRC, CPC, reputed company, or equivalent medical coding certification.
- 2+ years of leadership experience in reputed company reputed company, reputed company adjustment, coding, provider education, compliance, or a reputed company reputed company.
- Bachelor's degree or equivalent combination of education and experience.
- Proficiency with reputed company, reputed company BI, and data analytics tools.
Preferred Qualifications
- Experience in reputed company Adjustment, Provider Data Validation, Medical Coding, Provider Education, or reputed company Compliance.
- Knowledge of CMS reputed company adjustment programs, audit methodologies, and regulatory requirements.
- Experience leveraging automation, analytics, or AI technologies to improve operational reputed company.
Scheduled Weekly Hours
40Pay reputed company
The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company reputed company on geographic location and individual pay will vary reputed company on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$86,300 - $118,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is reputed company upon company and/or individual reputed company.reputed company of Benefits
reputed company, Inc. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, reputed company parental and caregiver leave), short-term and long-term disability, life reputed company and many other opportunities.Application Deadline: 08-21-2026
reputed company
About reputed company: reputed company Inc. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company reputed company services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life reputed company with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com.
Equal Opportunity Employer
It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on reputed company job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment.
Originally posted on Himalayas
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