Provider Audit & Education Lead - Remote

Texas Health Institute; Bangor, Northern (ME, KY); Hybrid; USD 92,000 - 164,000; Full time

Job summary

Optum Insight is hiring a Manager to lead Provider Audit & Education services for assigned MPP clients. You will manage audit, education, compliance, and performance-improvement activities to enhance coding accuracy and provider engagement.

You will travel ~25-35% to client sites and serve as the primary operational contact, collaborating with internal teams and client stakeholders to ensure successful program execution. Remote work is available within the U.S.

Qualifications

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

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
• 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 and documentation
• Analyze operational and audit data to identify trends, risks, and opportunities
• Deliver reporting and recommendations that support client outcomes and decisions
• Identify and implement process improvements that enhance efficiency, quality, and service delivery
• Promote best practices and support operational excellence across teams and clients
• Ensure compliance with coding, documentation, reimbursement, and regulatory requirements
• Communicate regulatory updates and support quality, compliance, and professional development
• Lead or support special projects, client implementations, and program expansion
• Represent the department in client engagements, reviews, and education activities
• Make decisions on workload, resources, and priorities
• Evaluate performance and escalate significant risks when appropriate
• Manage team performance through coaching, feedback, and development planning
• Foster engagement, accountability, continuous learning, and expertise
• Monitor and communicate performance results
• Ensure goals and quality standards are achieved

Skills

Coding certification

Healthcare revenue cycle

Supervisory experience

Operations management

Coding/reimbursement knowledge

MS Office

Project management

Relationship building

Travel willingness

Tools

Reporting tools

Job description

Optum Insight is hiring a Manager to lead Provider Audit & Education services for assigned MPP clients. You will manage audit, education, compliance, and performance-improvement activities to enhance coding accuracy and provider engagement.

You will travel ~25-35% to client sites and serve as the primary operational contact, collaborating with internal teams and client stakeholders to ensure successful program execution. Remote work is available within the U.S.