At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Job Description

A bit about this role :

The Outpatient Coder Program Manager will play a key role in supporting the execution and quality of inpatient and outpatient audit reviews by serving as a coding resource with the ability to support clinical review alongside program owners. This role will assist with audit quality, provider escalations, and appeals to help ensure audit accuracy and defensibility. The position is best suited for individuals who bring comprehensive coding experience alongside clinical insight to enhance audit quality and accuracy. It is essential to maintaining the high standards of coding compliance, clinical accuracy, and overall audit integrity across all payment integrity programs.

Your Responsibilities and Impact will include:

• Support the execution of inpatient and outpatient audit reviews by providing clinical and coding expertise to program owners

• Assist with provider escalations and appeals by reviewing documentation and contributing to defensible, high-quality responses

• Participate in quality review activities to ensure audit findings meet clinical, coding, and regulatory standards

• Collaborate with program owners, coders, and clinical staff to identify documentation or coding issues that impact audit accuracy

• Work with internal teams and offshore partners to promote consistency, accuracy, and compliance in audit-related activities

• Contribute to the development of educational materials, audit templates, and process improvements that support audit integrity

• Support program leadership by identifying trends in disputes or escalations and recommending opportunities for corrective action
  

Required skills and experience:

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS) required

• Minimum of 5 years of experience in outpatient coding, auditing, and payment integrity compliance

• Strong experience in coding audits

• Proven ability to support audit processes, including provider escalations and appeals

• Operational Discipline

Desired skills and experience:

• Active Registered Nurse (RN) license or clinical background preferred

• Bachelor’s Degree

• Strong communication and interpersonal skills to collaborate effectively with internal teams and external stakeholders

• Experience working with offshore vendors or remote teams

• Ability to manage multiple priorities and meet deadlines in a fast-paced environment

#LI-DS1
#LI-Remote

Salary range: $76,000 - $120,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.