Director, Clinical Audit

Applicant Data Privacy And Protection Notice

Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.

Work Location:

• Fully Remote - U.S.

Position:

The Director of Clinical Audit is responsible for managing the Payment Integrity Clinical Validation and Hospital Billing Validation Audit businesses providing leadership for Clinical Audit managers and auditor staff.   This position will network and maintain effective communication with internal and external personnel including staff, clients, and management to ensure audit accuracy and integrity in accordance with client contracts and guidelines. The Director will be responsible for program and product development.

Core Responsibilities:

• Utilize audit experience and industry best practices to lead a team of Clinical Auditors to deliver timely and accurate audit results

• Direct training and professional development for the clinical team

• Manage client implementations for Clinical Validation and Hospital Billing Validation

• Assist in creating pipeline and revenue forecasts

• Monitor monthly goals and key performance indicators to ensure budget objectives are met or exceeded

• Attend client business reviews and act as the subject matter expert for clients and clinical staff

• Provide resolution for client issues, identify needs and suggest new audit opportunities

• Ensure accuracy of audits through acquired knowledge of client policies and contract information

• Development and support of auditors to meet and exceed documented productivity standards

• Identify and review potential clinical audit inconsistencies, target areas of improvement and product development, and communicate findings with management and audit staff

Requirements:

• Graduate of an accredited College or University with an

• Active, unrestricted R.N. license

• 5 years of management experience

• Diverse acute care clinical nursing experience

• 3 years of clinical post payment auditing experience

• Experience with national evidence-based screening guidelines

Preferred Qualifications:

• Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), or equivalent coding certification

• Ability to perform in-depth analysis of documentation relating to appropriateness of clinical documentation

• Experience with inpatient coding requirements and competency in ICD-10 CM & PCS

Working Conditions/Physical Requirements:

• General office demands

Travel:

• No travel required

Unique Benefits*:

• Flexible work environments

• Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets

• Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships

• Employee wellbeing programs and generous health plans

• Educational assistance programs

• US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions

• Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies

• Learn more at https://careers.changehealthcare.com

• *Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.

Diversity and Inclusion:

• At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.

• Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity

Feeling Inspired? Ready to #MakeAChange? Apply today!

#li-remote

New York and New Jersey Residents Only: The salary range for New York City, NY and Westchester County, NY is $97,290 - $203,040.  The salary range for Ithaca, NY is $84,600– $169,200.  The salary range for Jersey City, NJ is $101,520 – $203,040.  Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, Change Healthcare offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with Change Healthcare, you’ll find a far-reaching choice of benefits and incentives.

Diversity, Equity & Inclusion:

•At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
•Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity

Feeling Inspired? Ready to #MakeAChange? Apply today!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety and well-being of our team members and our communities. As such, some individuals may be required to disclose COVID-19 vaccination status prior to or during employment. Certain roles may require COVID-19 vaccination and/or testing as a condition of employment. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information,  national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Applicant Data Privacy And Protection Notice