Remote Lead Certified Coder - QA & Operational Integrity

UPMC; Pittsburgh (Allegheny County); Remote; USD 110,000 - 140,000; Full time

Job summary

UPMC Health Plan is seeking a Lead Certified Coder Quality Assurance Operational Integrity (QAOI) to oversee QA and risk management across ISD products and services. This remote, full-time role emphasizes leadership, guidance, and compliance with healthcare standards.

The ideal candidate holds a CPC certification, at least 7 years in QA/risk management, and demonstrates strong analytical and project-management skills.

Qualifications

• Bachelor's degree or equivalent professional experience; 7 years in quality assurance, operational controls, risk management, auditing, or customer service.
• CIA certification preferred.
• 1 year experience leading or facilitating meetings.
• 1 year experience coaching and mentoring.
• Strong healthcare portfolio knowledge or experience auditing in a regulated industry.

Responsibilities

• Lead and mentor QAOI professionals, guiding quality assurance and operational integrity reviews.
• Educate leadership on risk management best practices and protocols.
• Coordinate workgroups/projects to drive results and efficiency.
• Manage workload and distribute assignments; supervise day-to-day activities.
• Provide training and support as needed; act as process and technical expert.

Skills

Leadership

Mentoring

Communication

Project management

Education

Bachelor's degree

Tools

MS Teams

Word

Excel

Visio

Job description

UPMC Health Plan is seeking a Lead Certified Coder Quality Assurance Operational Integrity (QAOI) to oversee QA and risk management across ISD products and services. This remote, full-time role emphasizes leadership, guidance, and compliance with healthcare standards.

The ideal candidate holds a CPC certification, at least 7 years in QA/risk management, and demonstrates strong analytical and project-management skills.