DRG Coding & Clinical Validation Audit Lead

Elevance Health; Indianapolis (IN); Hybrid; USD 115,020 - 207,216; Full time

Benefits offered by this job

Benefits package

Job summary

Elevance Health is seeking a Manager of DRG Coding Audit-Program/Project to lead a high‑performing team auditing inpatient records for DRG accuracy and regulatory integrity across the organization and clients.

The role sets audit strategy, partners with clinical, compliance, provider engagement and data analytics, hires and coaches staff, analyzes trends, designs scope, and builds metrics and reporting tools to drive high‑value improvements in coding governance.

Qualifications

• BA/BS degree required; minimum 5 years in project/program management, process reengineering, organizational design, or implementation.
• Will travel to worksite and other locations as necessary.
• Experience leading DRG/inpatient auditing and cross-functional teams is a plus.

Responsibilities

• Set strategic direction for audit methodologies and ensure audits meet best practices.
• Collaborate with clinical, compliance, provider engagement, and data analytics teams.
• Hire, train, coach, and evaluate performance of direct reports.
• Analyze audit trends and DRG shifts to inform strategy and actions.
• Plan program scope and design, and develop reporting metrics.
• Lead documentation efforts to support business objectives and ensure consistency.

Skills

Project management

Process reengineering

Organizational design

Implementation

Leadership

Education

BA/BS degree

Job description

Elevance Health is seeking a Manager of DRG Coding Audit-Program/Project to lead a high‑performing team auditing inpatient records for DRG accuracy and regulatory integrity across the organization and clients.

The role sets audit strategy, partners with clinical, compliance, provider engagement and data analytics, hires and coaches staff, analyzes trends, designs scope, and builds metrics and reporting tools to drive high‑value improvements in coding governance.