Manager, Provider Audit and Education - Remote

Optum; Bangor (ME); Remote; USD 92,000 - 164,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Incentive and recognition programs

Job summary

Optum is seeking a Manager, Provider Audit and Education to lead day-to-day audit and education services for our Managed Performance Partnership clients. You will oversee audit, education, compliance, and performance improvement activities to enhance coding accuracy, documentation quality, regulatory compliance, and provider engagement.

You will act as the primary operational contact for clients, collaborate with internal teams, monitor performance, and drive improvements in quality, efficiency,

Qualifications

• Professional coding certification (CPC, CCS, CRC, COC, RHIA, RHIT, or equivalent)
• 5+ years experience in healthcare revenue cycle, coding, provider audit, compliance, or related operations
• 1+ years supervisory/management experience
• Experience managing operational workflows and client deliverables
• Advanced proficiency with Microsoft Office (Excel, PowerPoint, Outlook) and reporting tools
• Strong project management, analytical, and organizational skills
• Ability to travel up to 35% domestically

Responsibilities

• Lead daily Provider Audit & Education operations meeting performance, quality, and service goals
• Coach and develop teams, partner across functions for operational excellence
• Serve as primary client contact and build relationships to support needs
• Lead client discussions on performance, audit results, and education strategies
• Oversee programs to ensure quality, consistency, compliance, and client alignment
• Drive provider and staff education initiatives to improve coding accuracy and documentation
• Analyze data to identify trends, risks, and improvement opportunities
• Deliver reporting and recommendations to support client outcomes
• Identify and implement process improvements for efficiency and quality
• Promote best practices across teams and clients
• Ensure compliance with coding, documentation, reimbursement, and regulatory requirements

Skills

Coding certification

Healthcare revenue cycle

Supervisory experience

Workflow management

Reimbursement knowledge

MS Office proficiency

Project management

Relationship building

Willingness to travel

Tools

Microsoft Excel

PowerPoint

Reporting tools

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Manager, Provider Audit and Education - Remote (2378294)

Manager, Provider Audit and Education - Remote - 2378294

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

Position Summary

Reporting to the AVP, Provider Audit & Education, the Manager is responsible for assisting in leading the day-to-day operations of Provider Audit & Education services for assigned Optum Managed Performance Partnership (MPP) clients. This role manages audit, education, compliance, and performance improvement activities designed to enhance coding accuracy, documentation quality, regulatory compliance, and provider engagement.

The Manager serves as a primary operational contact for assigned clients and collaborates with internal teams and client stakeholders to support successful execution of audit and education programs. This role is responsible for monitoring operational performance, ensuring service excellence, supporting team development, and identifying opportunities to improve quality, efficiency, and client outcomes.

This position requires regular engagement with client organizations and travel to client sites to support relationship management, operational assessments, provider education initiatives, performance reviews, and operational meetings. Travel is expected to be approximately 25-35% and may vary based on client needs and business priorities.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Lead daily Provider Audit & Education operations, ensuring performance, quality, and service goals are met
• Coach and develop teams while partnering across functions to drive operational excellence and engagement
• Serve as the primary client contact, building solid relationships and addressing operational needs
• Lead client discussions on performance, audit results, education strategies, and issue resolution
• Oversee audit and education programs to ensure quality, consistency, compliance, and client alignment
• Drive provider and staff education initiatives to improve coding accuracy, documentation, and performance
• Analyze operational and audit data to identify trends, risks, and improvement opportunities
• Deliver reporting and recommendations that support client outcomes and business decisions
• Identify and implement process improvements that enhance efficiency, quality, and service delivery
• Promote best practices and support operational excellence initiatives across teams and clients
• Ensure compliance with coding, documentation, reimbursement, and regulatory requirements
• Communicate regulatory updates and support quality, compliance, and professional development efforts
• Lead or support special projects, client implementations, and program expansion initiatives
• Represent the department in client engagements, operational reviews, and education activities
• Make operational decisions regarding workload, resources, priorities, and service delivery
• Evaluate performance, implement improvements, and elevate significant risks when appropriate
• Manage team performance through coaching, feedback, evaluations, and development planning
• Foster engagement, accountability, continuous learning, and subject matter expertise
• Monitor and communicate operational, quality, and client performance results
• Ensure goals, service commitments, and quality standards are consistently achieved

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• Professional coding certification (CPC, CCS, CRC, COC, RHIA, RHIT, or equivalent)
• 5+ years of experience in healthcare revenue cycle, coding, provider audit, compliance, clinical documentation improvement, or healthcare operations
• 1+ years of supervisory, team lead, or management experience
• Experience managing operational workflows, performance metrics, and client deliverables
• Solid understanding of healthcare reimbursement, coding, compliance, documentation, and provider operations
• Advanced proficiency with Microsoft Office applications, including Excel, PowerPoint, Outlook, and reporting tools
• Proven solid project management, analytical, problem-solving, and organizational skills
• Proven ability to build productive working relationships with providers, clients, operational leaders, and internal partners
• Proven ability and willingness to travel up to 35% domestically

Preferred Qualifications

• Experience supporting multiple health system or physician practice clients in a consulting, managed services, or operational environment
• Experience with provider audit programs, coding quality reviews, risk adjustment, or provider education initiatives
• Experience using healthcare analytics and reporting platforms to drive performance improvement
• Knowledge of E/M auditing, Medicare regulations, and documentation improvement strategies
• Proven excellent written, verbal, presentation, and interpersonal communication skills
• Proven ability to manage multiple priorities in a fast-paced environment

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.