Senior Manager, Program Integrity (CPC)

Job Summary

A company is looking for a Senior Manager, Program Integrity.

Key Responsibilities

• Implement and optimize medical record auditing procedures for improved quality and timeliness
• Oversee project plans and manage team performance, ensuring compliance with regulatory standards
• Analyze coding review guidelines and maintain documentation to minimize risks of fraud and errors

Required Qualifications

• Bachelor's degree or equivalent work experience is required
• Minimum of five (5) years of experience in medical policy and management
• Health plan experience is required
• Experience with Facets and clinical editing systems is required
• Certification as a Medical Coder (CPC, RHIT or RHIA) is required