DRG Coding Audit Leader – Inpatient Compliance

Elevance Health; Severn (MD); Híbrido; USD 115.000 - 207.000; Jornada completa

Descripción de la vacante

Elevance Health in Maryland is seeking a DRG Coding Audit Manager-Program/Project to lead a high-performing team auditing inpatient medical records for DRG accuracy and compliance. The role focuses on identifying coding discrepancies and guiding audit methodologies in line with payer requirements.

You will collaborate across clinical, compliance, provider engagement, and data analytics teams, hire and coach staff, analyze audit trends, and develop reporting tools to drive program success in a

Formación

• BA/BS required with 5+ years in project/program management or related fields.
• Experience in process reengineering and organizational design preferred.
• Travel to worksite and other locations as necessary.

Responsabilidades

• Sets the strategic direction for audit methodologies and oversees team development.
• Collaborates cross-functionally with clinical, compliance, provider engagement, and data analytics teams.
• Hires, trains, coaches, counsels and evaluates performance of direct reports.
• Analyzes audit trends, DRG shifts, and uses financial outcomes to inform strategy.
• Plans program/project scope and design.
• Develops metrics and reporting tools for the program.

Conocimientos

Leadership

Project management

DRG auditing

Inpatient coding

ICD-10 coding

Cross-functional collaboration

Educación

BA/BS degree

Descripción del empleo

Elevance Health in Maryland is seeking a DRG Coding Audit Manager-Program/Project to lead a high-performing team auditing inpatient medical records for DRG accuracy and compliance. The role focuses on identifying coding discrepancies and guiding audit methodologies in line with payer requirements.

You will collaborate across clinical, compliance, provider engagement, and data analytics teams, hire and coach staff, analyze audit trends, and develop reporting tools to drive program success in a