Note: The job is a remote job and is open to candidates in USA. Optum Insight improves the flow of health data and information to create a more connected healthcare system. The Manager, Provider Audit and Education leads audit, education, compliance, and performance improvement operations for assigned clients while managing client relationships, team development, service quality, and operational outcomes.
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 escalate 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
Skills
- 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
- 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
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Remote work from anywhere within the U.S.
- Development for other roles you may be interested in
Company Overview
Company H1B Sponsorship