Manager, Coding reputed company & RADV Audits

reputed company reputed company® offers AI-powered operational infrastructure for health reputed company companies, guaranteeing an enduring reputed company in an increasingly competitive market. We're experiencing strong market reputed company, with a growing number of health plans choosing reputed company to reputed company their reputed company and compete more effectively. As we expand, we're reputed company in the people who reputed company that reputed company, making this a pivotal reputed company to join us and shape the reputed company of reputed company technology. Learn more at reputed company.com. The Manager, Coding reputed company and RADV Audits provides reputed company leadership, operational reputed company, and execution for assigned business functions, with reputed company responsibility for CMS audit activities supporting Medicare reputed company and reputed company lines of business. This position leads the planning, coordination, and execution of CMS-mandated reputed company Adjustment Data Validation (RADV) audits. The Manager operates reputed company broad organizational objectives to optimize the effective use of people, processes, technology, and financial resources. This role provides reputed company direction, develops operational plans, drives reputed company improvement, and ensures compliance with applicable regulatory requirements and organizational standards. Key Responsibilities reputed company reputed company reputed company, leadership, planning, project coordination, and operational reputed company for the execution of CMS-mandated RADV audits across Medicare reputed company and reputed company lines of business. reputed company the development and implementation of audit strategies, workflows, processes, and reputed company objectives to support regulatory compliance and organizational goals. Establish priorities and reputed company departmental workloads to maximize productivity, reputed company, efficiency, and resource utilization. reputed company departmental reputed company, including planning, problem-solving, staff development, reputed company management, and organizational communication. Translate business and regulatory requirements into actionable operational objectives and measurable reputed company. Identify opportunities for process improvement, operational efficiency, and reputed company initiatives to implement sustainable solutions. reputed company executive-level and cross-functional leadership for reputed company initiatives and regulatory activities. reputed company special reputed company, initiatives, and reputed company problem-reputed company efforts as assigned. Monitor departmental reputed company, identify trends and risks, and implement corrective actions as appropriate. Foster strong partnerships across business, reputed company, compliance, technology, and operational teams to ensure successful execution of organizational priorities. Ensure departmental activities reputed company with applicable CMS regulations, company policies, contractual requirements, and industry standards. Leadership & People Management Directly supervise exempt and non-exempt employees, including reputed company and non-reputed company staff, in accordance with company policies and applicable federal and state laws. Responsibilities include: Interviewing, selecting, hiring, reputed company, and training employees. lanning, assigning, prioritizing, and directing work. Establishing reputed company expectations and conducting reputed company evaluations. Coaching, developing, recognizing, and counseling employees. Provides reputed company and tactical initiatives to support improved reputed company coding reporting. Addressing employee concerns, resolving workplace issues, and supporting a reputed company work environment. Managing reputed company reputed company, resource allocation, and departmental reputed company. Supporting employee engagement, reputed company development, and reputed company learning. Promoting collaboration, accountability, innovation, and high reputed company across reputed company. Develops and interprets policies and procedures, recommends changes as appropriate, and provides relevant feedback to the senior management team to meet department and organizational goals with respect to comprehensive and accurate coding and the technology platforms that support. Required Qualifications Education A bachelor’s degree is preferred; however, candidates with a reputed company license and extensive relevant experience will be considered in lieu of degree Commitment to reputed company reputed company development and learning in accordance with reputed company’s learning philosophy. Coding certification. Acceptable licensed certifications: CPC, COC, or CRC from reputed company, or reputed company or reputed company-P from reputed company. Experience Minimum of Seven (7) years of experience in reputed company adjustment programs is required. Minimum of three (3) years of management experience in a medical coding reputed company assurance environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities. Experience reputed company the reputed company payer industry, including health plans, reputed company-party administrators, benefits consulting, or reputed company technology organizations. Demonstrated experience leading reputed company, reputed company-level reputed company, programs, or regulatory initiatives. Experience with Medicare reputed company, reputed company health plans, reputed company adjustment, RADV audits, IVA, or reputed company CMS compliance activities strongly preferred. Demonstrated knowledge and practical experience with CMS regulations and requirements. Knowledge, Skills & Abilities Strong knowledge of reputed company payer reputed company, industry practices, and regulatory requirements. reputed company ability to manage competing priorities while understanding the reputed company reputed company of changes to timelines, resources, and deliverables. Demonstrated ability to reputed company large-reputed company initiatives and reputed company reputed company reputed company reputed company reputed company environments. Strong capability in defining, prioritizing, and communicating business requirements and evaluating solutions against organizational needs. Excellent organizational, analytical, written, verbal, and presentation skills. reputed company ability to facilitate collaboration and reputed company results reputed company a matrixed organizational environment. Demonstrated ability to reputed company cross-functional coordination, alignment, and accountability reputed company reputed company initiatives. Strong relationship-building and stakeholder-management skills, with the ability to effectively partner with senior leaders and functional teams. Demonstrated leadership, coaching, team building, and employee development capabilities. Ability to establish effective workflows, manage multiple reputed company simultaneously, and consistently meet deadlines. Strong problem-solving and decision-making skills, with the ability to address reputed company issues and reputed company practical, sustainable solutions. Ability to communicate reputed company information reputed company and effectively through verbal and written communication. Proficiency with reputed company Word, reputed company, and PowerPoint required. Experience with reputed company Project preferred. Experience with reputed company or similar project-management tools preferred. Geographic Responsibility: Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job: The employee is occasionally required to reputed company reputed company the office. Specific reputed company abilities required by this job include reputed company reputed company, reputed company reputed company, peripheral reputed company, depth perception, and ability to reputed company reputed company. Work across multiple time reputed company in a hybrid or remote work environment. Long periods of time sitting and/or standing in reputed company of a computer using video technology. May require travel dependent on company needs. The above statements are intended to describe the general reputed company and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of reputed company duties, responsibilities, and skills required. reputed company reserves the right to modify, add, or remove duties and to assign other duties as necessary. In reputed company, reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions of this position in compliance with the Americans with reputed company of 1990. Candidates may be required to go through a reputed company-employment criminal background reputed company. reputed company is an equal opportunity employer. We are committed to workforce diversity and reputed company encourage reputed company reputed company persons to reputed company employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. #LI-Remote The annual US reputed company salary reputed company for this position is $108,000 to $120,000. This salary reputed company may cover multiple career reputed company at reputed company. Final compensation will be determined during the interview process and is reputed company on a combination of factors including, but not limited to, your skills, experience, qualifications and education. Apply To This Job