Lead Certified Coder – QAOI & Integrity (Hybrid)

UPMC Corporate Services; Pittsburgh (Allegheny County); Hybrid; USD 110,000 - 135,000; Full time

Job summary

UPMC Health Plan is seeking a Certified Coder Quality Assurance Operational Integrity Lead to drive QA across ISD products and services. The role provides frontline leadership to professionals conducting QA and risk assessments, with a focus on operational integrity and compliance while supporting leadership to achieve initiatives.

The QAOI Lead will guide teams across clinical, financial, operational, and IT domains, emphasizing process excellence, training, and efficiency.

Qualifications

• Bachelor's degree or equivalent professional experience with 7 years in QA, risk, or auditing.
• CIA certification preferred.

Responsibilities

• Lead QA and ISD teams to drive quality assurance and operational integrity initiatives.
• Educate leadership on risk management protocols and QA best practices.
• Mentor and coach staff; coordinate workgroups to deliver results on time.
• Allocate workload and supervise day-to-day activities; support new staff orientation.
• Communicate findings clearly with stakeholders and maintain QA documentation.

Skills

Quality assurance

Risk management

Leadership

Mentoring

Project management

Analytical skills

Communication skills

Data extraction

Visio

Education

Bachelor's degree

Tools

MS Teams

Word

Excel

Visio

Job description

UPMC Health Plan is seeking a Certified Coder Quality Assurance Operational Integrity Lead to drive QA across ISD products and services. The role provides frontline leadership to professionals conducting QA and risk assessments, with a focus on operational integrity and compliance while supporting leadership to achieve initiatives.

The QAOI Lead will guide teams across clinical, financial, operational, and IT domains, emphasizing process excellence, training, and efficiency.