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Dual-Track Subject Matter Expertise: Serve as the definitive Subject Matter Expert (SME) on complex billing guidelines, reimbursement policies, and CMS regulations (e.g., NCCI, LCD/NCDs), acting as the primary point of escalation for delivery teams and internal cross-functional partners on high-complexity claims. The Senior Manager of Payment Integrity is responsible for data-driven research and root-cause analyses related to payment integrity provider disputes and escalations to facilitate resolution and drive education in support of Devoted’s collaborative provider relationships.

Devoted Health Services

Senior Manager, Payment Integrity Disputes

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The Payment Integrity Inpatient Program Manager is responsible for overseeing assigned inpatient Payment Integrity programs, including audit, appeals, quality, and review processes across internal teams, offshore staff augmentation, and external vendors. Perform complex and escalated inpatient Payment Integrity audits, including clinical validation, DRG coding validation, readmission, and hospital bill audit reviews, and provide clear, defensible audit rationale and determinations.

Payment Integrity Program Manager

Serves as the central clinical communication hub, coordinating with physicians, clinicians, patients, families, and interdisciplinary partners to manage orders, labs, changes in condition, and transitions of care. Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations.

YEAR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc.

Patient Care Manager OT, PT Or ST Easton, MA

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UnitedHealth Group Inc

Patient Care Manager OT, PT or ST Easton, MA

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Lead CDI & Coding Thought Partnership: Serve as the CDI subject matter expert and strategic partner to Risk Adjustment leadership and cross-functional teams, contributing to the Coding Steering Workgroup and ensuring enterprise alignment with ICD-10-CM guidelines, AHA Coding Clinic, CMS guidance, and AHIMA guidance. Develop Clinical Logic & Program Strategy: Collaborate with clinical and operational leaders in workgroups to refine and test risk adjustment insights logic using multi-source clinical data to support embedding high quality information in provider workflows.

Clinical Documentation Manager

The Role: The Payment Integrity Project Manager will report to the Program Manager, Payment Integrity and will lead the implementation of critical projects focused on improving how Blue Cross ensures that health care claims are paid correctly. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

BlueCross and BlueShield of Massachusetts

Payment Integrity Project Manager

Works with hospital and physician group contract staff to analyze existing payor contract participation and payor renewals in order to develop a strategic plan to renegotiate PLLC and HLLC contracts into consolidated BILHPN contracts. Monitors and evaluates the potential impact to BILHPN of changes in the current healthcare environment including the activities of the Health Care Policy Commission, applicable federal and state regulations including Chapter 224 (cost containment) and programmatic changes at the State Health Connector.

Lahey Hospital and Medical Center

Sr. Contract Manager | BILH Performance Network

OTHER

GPAC (Growing People and Companies) is an award-winning search firm specializing in placing quality professionals within multiple industries across the United States since 1990. I'm recruiting medical office administrators and practice managers for dermatology, plastic surgery, and aesthetic/med spa practices across Rhode Island.

Gpac’s mission is to be the preferred staffing and recruitment solution by effectively delivering and connecting talent with successful companies and organizations. 
 
Our team, with collective experience of over 250 years, is passionate about wh

Gpac

Medical Office Administrator / Practice Manager

LogicMelon

Thea Pharma markets a suite of leading eye-care drugs that have been approved by the U.S. Food and Drug Administration (FDA), including CYKLX, ZOLYMBUS, IYUZEH, Zioptan®, Cosopt®, Cosopt® PF, Azasite®, Akten®, and Betimol®, as well as AcellFX Acellular Amniotic Membrane and the portfolio of iVIZIA dry-eye drops and eyelid hygiene products. Strategic Payer Account Management: Develop and execute account-specific strategies for an assigned national portfolio of priority payer accounts, including national and regional commercial health plans, MACs, PBMs and other strategically important payer organizations, in alignment with portfolio and brand access objectives.

Thea Pharma Inc.

Payer Account Manager

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The Role: The Payment Integrity Senior Project Manager will report to the Senior Director, Payment Integrity and will lead the implementation of critical projects focused on improving how Blue Cross ensures that health care claims are paid correctly. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

Blue Cross and Blue Shield of Massachusetts Inc

Program Manager II

Since our inception, we've touched the lives of hundreds of thousands of patients and have emerged as a leading and distinguished dental organization, led by dentists. By placing patients and providers at the core of our approach, we're breaking new ground in the world of dentistry.

Dental365

Dental Office Manager

GreenHouseAPI

Relevant Experience: Five or more years of experience in clinical nursing, hospital-based care, healthcare audit, Payment Integrity, utilization management, quality review, or a related healthcare environment, including demonstrated experience reviewing inpatient hospital readmissions. The Clinical Readmission Manager is responsible for conducting prepayment and post-payment clinical reviews of inpatient hospital admissions and subsequent admissions to the same or a related hospital within 30 days of the prior discharge date.

Payment Integrity Clinical Readmission Manager

The Victim Services Case Manager provides trauma-informed case management, advocacy, crisis intervention, safety planning, and resource coordination to adult victims and survivors of crime. Working within the Women's Center, this position helps survivors achieve safety, stability, and recovery by connecting them with medical, behavioral health, housing, legal, financial, and community resources.

SSTAR

Case Manager - Domestic Violence Case Manager

ATSOndemand

Coordinate with Medicaid Enterprise System project teams, IT architects, business owners, finance, OFFR, procurement, legal, and vendors to collect and validate project scope, schedules, budgets, risks, outcomes, contract information, and supporting documentation. " Support budget planning and forecasting for D&A initiatives by compiling inputs from project teams, vendors, finance partners, and leadership; identifying variances; and preparing funding status updates.

Mindlance

Project manager

jobdiva

Facilitate timely workup of patients for access management, dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination of care with the multidisciplinary renal team. Frequently interacts with subordinate supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers.

Fresenius Medical Care AG & Co KGaA

Dialysis Clinical Manager Registered Nurse - RN

Bill every properly documented and authorized service accurately and on time, minimize preventable denials, aggressively follow outstanding claims, and protect Brockton Home Health Care Agency's revenue while maintaining billing integrity and compliance. The position is responsible for helping manage the full billing cycle: Service Provided Documentation Completed Authorization Verified Eligibility Verified Claim Prepared Claim Submitted Claim Accepted Payment Received Payment Reconciled .

Brockton Home Health Care Agency LLC

BILLING MANAGER FOR HOME HEALTH

Gethired

At WECTEC Staffing Services, a wholly-owned subsidiary of Westinghouse Electric Company LLC, we recognize that our employees are our most valuable asset and we seek to identify, attract and recruit the most qualified talent while recognizing and encouraging the value of diversity in the global workplace. WECTEC Staffing Services delivers customer-focused solutions, offering everything from high-volume, cost-effective staffing to specialized niche roles, while maintaining best-in-class service.

HOUR

Westinghouse Electric Co LLC

SCADA Technical Project Manager

Fresenius Medical Care North America is a wholly owned subsidiary of Fresenius Medical Care AG & Co. KGaA, located in Bad Homburg, Germany. Through our dialysis services entity, Fresenius Medical Services, we operate more than 2,100 outpatient dialysis clinics in the U.S. Our Renal Therapies Group is responsible for the manufacture and distribution of a variety of dialysis products and equipment, including dialysis machines, dialyzers and other dialysis-related supplies. 

Fresenius Medical Care

Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Position Summary: Reporting to and in collaboration with the Director of Site Operations, the Primary Care Practice Manager is responsible for all day-to-day.

Practice Manager -Urgent Care-Middleboro

4+ years of experience in healthcare analytics, large databases, data verification, data management, table creation and indexing, query optimization, utilization of stored procedures, developing complex queries using SQL or other coding languages, and lead or management experience. Position Purpose: The Manager, Medical Economics drives the execution of analytics strategy through the discovery, development, and implementation of leading-edge analytics that answer important business questions.

Coding Manager Jobs in Providence, RI

Senior Manager, Payment Integrity Disputes Devoted Health Services

Payment Integrity Program Manager Devoted Health Services

Patient Care Manager OT, PT Or ST Easton, MA UnitedHealth Group Inc.

Patient Care Manager OT, PT or ST Easton, MA UnitedHealth Group Inc

Clinical Documentation Manager Devoted Health Services

Payment Integrity Project Manager BlueCross and BlueShield of Massachusetts

Sr. Contract Manager | BILH Performance Network Lahey Hospital and Medical Center

Medical Office Administrator / Practice Manager Gpac

Payer Account Manager Thea Pharma Inc.

Program Manager II Blue Cross and Blue Shield of Massachusetts Inc

Dental Office Manager Dental365

Payment Integrity Clinical Readmission Manager Devoted Health Services

Case Manager - Domestic Violence Case Manager SSTAR

Project manager Mindlance

Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical Care AG & Co KGaA

BILLING MANAGER FOR HOME HEALTH Brockton Home Health Care Agency LLC

SCADA Technical Project Manager Westinghouse Electric Co LLC

Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical Care

Practice Manager -Urgent Care-Middleboro Lahey Hospital and Medical Center

Manager, Medical Economics Centene Corporation Group

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