Hybrid DRG Coding Audit Manager — Lead Auditor & Strategy

Elevance Health (Anthem); Washington (District of Columbia); Hybrid; USD 115,000 - 207,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a DRG Coding Audit Manager to lead a high-performing team auditing inpatient records for DRG accuracy and compliance. The role emphasizes cross-functional collaboration, strategic audit direction, and regulatory integrity across multiple sites.

The ideal candidate has 5+ years in DRG auditing or inpatient coding, with leadership experience and ICD-10 coding expertise. Hybrid work with in-office days supports collaboration, while travel to some locations may be required.

Qualifications

• Minimum BA/BS and 5+ years in project/program management or related fields.
• Travel to worksite and other locations as necessary.

Responsibilities

• Sets strategic audit direction, oversees team development, and ensures audits meet industry and payer requirements.
• Collaborates with clinical, compliance, provider engagement, and data analytics teams to align audits with program goals.
• Hires, trains, coaches, and evaluates direct reports.
• Analyzes audit trends, DRG shifts, and uses financial outcomes to guide strategy.
• Plans program scope, design, and develops reporting tools and metrics.
• Analyzes variance to the program plan and documents support for business objectives.
• Champions local stakeholders and tactical decision-makers.
• Develops high-quality concepts and process improvement recommendations.
• Uses ICD-10 coding expertise and clinical guidelines to substantiate conclusions.

Skills

DRG auditing

Project management

Leadership

Education

BA/BS

Tools

ICD-9/10CM

MS-DRG

APR-DRG

Job description

Elevance Health is seeking a DRG Coding Audit Manager to lead a high-performing team auditing inpatient records for DRG accuracy and compliance. The role emphasizes cross-functional collaboration, strategic audit direction, and regulatory integrity across multiple sites.

The ideal candidate has 5+ years in DRG auditing or inpatient coding, with leadership experience and ICD-10 coding expertise. Hybrid work with in-office days supports collaboration, while travel to some locations may be required.