Skip to main content
Find Your Path

Senior Clinical Audit Manager - Remote (Anywhere US)

Job ID R26155

Location

Lombard, Illinois, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, Oregon, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Oklahoma, Alabama, Arizona, Arkansas, California, Connecticut, Washington, DC, Delaware, Florida, Georgia, Idaho, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio Lombard, Illinois, United States of America; VIRTUAL, Pennsylvania, United States of America; VIRTUAL, Rhode Island, United States of America; VIRTUAL, South Carolina, United States of America; VIRTUAL, South Dakota, United States of America; VIRTUAL, Tennessee, United States of America; VIRTUAL, Texas, United States of America; VIRTUAL, Utah, United States of America; VIRTUAL, Vermont, United States of America; VIRTUAL, Virginia, United States of America; VIRTUAL, Washington, United States of America; VIRTUAL, West Virginia, United States of America; VIRTUAL, Wisconsin, United States of America; VIRTUAL, Wyoming, United States of America; VIRTUAL, Massachusetts, United States of America; VIRTUAL, Michigan, United States of America; VIRTUAL, Minnesota, United States of America; VIRTUAL, Mississippi, United States of America; VIRTUAL, Missouri, United States of America; VIRTUAL, Montana, United States of America; VIRTUAL, Nebraska, United States of America; VIRTUAL, Nevada, United States of America; VIRTUAL, New Hampshire, United States of America; VIRTUAL, Oregon, United States of America; VIRTUAL, Indiana, United States of America; VIRTUAL, Iowa, United States of America; VIRTUAL, Kansas, United States of America; VIRTUAL, Kentucky, United States of America; VIRTUAL, Louisiana, United States of America; VIRTUAL, Maine, United States of America; VIRTUAL, Maryland, United States of America; VIRTUAL, Oklahoma, United States of America; VIRTUAL, Alabama, United States of America; VIRTUAL, Arizona, United States of America; VIRTUAL, Arkansas, United States of America; VIRTUAL, California, United States of America; VIRTUAL, Connecticut, United States of America; VIRTUAL, District of Columbia, United States of America; VIRTUAL, Delaware, United States of America; VIRTUAL, Florida, United States of America; VIRTUAL, Georgia, United States of America; VIRTUAL, Idaho, United States of America; VIRTUAL, New Jersey, United States of America; VIRTUAL, New Mexico, United States of America; VIRTUAL, New York, United States of America; VIRTUAL, North Carolina, United States of America; VIRTUAL, North Dakota, United States of America; VIRTUAL, Ohio, United States of America

Date posted 04/06/2022

Apply Now

Applicant Data Privacy And Protection Notice

Senior Clinical Audit Manager

Overview of Position

The Sr. Clinical Audit Manager is responsible for managing the Payment Integrity Clinical Validation and Hospital Billing Validation Audit teams.   The Sr. Clinical Audit Manager 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 Sr. Clinical Audit Manager will be responsible for program and product development, day-to-day operations and processes, and quality assurance.

What will be my duties and responsibilities in this job?

  • 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

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

  • Assist in the development and support of analysts to meet and exceed documented productivity standards

  • Performance of periodic quality assurance reviews and documentation analysis of audits to ensure consistency and accuracy in accordance with evidence-based criteria, client expectations, and contractual requirements

  • Training of audit staff in accordance with internal policies and procedures to assure consistency and accuracy of HBV reviews

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

  • Act as a point of contact and resource for clinical staff

What are the requirements needed for this position?

  • Graduate of an accredited College or University with an active and unrestricted R.N. license

  • 5 years of management experience

What critical skills are needed for you to consider someone for this position?

  • Diverse acute care clinical nursing experience

  • Clinical post payment auditing experience

  • Experience with national evidence-based screening guidelines

  • 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

  • Willingness to engage in both tactical hands-on work and strategic work, as needed, to manage and complete priorities

  • Ability to work independently and drive execution by understanding actions and performance necessary to motivate staff and provide an environment that strives for continuous improvement

  • Strong leadership skills with the ability to clearly communicate verbal or written expectations; outlines goals and objectives for all levels of staff within the team to achieve success

  • Excellent analytical, organizational, and prioritization skills

  • Ability to interface with all levels of the company including clients

  • Ability to manage multiple, concurrent priorities effectively in a fast-paced environment

  • Proficiency with Microsoft office and Excel

What other skills/experience would be helpful to have?

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

  • Bachelor’s degree preferred

What are the working conditions and physical requirements of this job?

  • General office demands/Home office

How much should I expect to travel?

  • No travel

#li-remote

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

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, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. 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 applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

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

Apply Now

You currently do not have any saved jobs.

Talent Acquisition Process

Apply

Visit our career site, create a profile, and submit your application. Make sure to observe the job description and see how your background can align to the requirements of the role.

Review

Once you apply for a job opening, the Sourcing Specialist or Talent Advisor will review your resume ensuring your background matches the minimum job requirements. Selected candidates will be invited for a phone screen.

Interview

Steps will vary by team, but typically include: Talent Advisor phone screen, hiring manager interview, and a combination of technical screens and panel interviews.

Offer

If you're selected, you can expect the Talent Advisor to reach out with specific offer details. During this stage you will be provided with an electronic offer letter and other new hire documents.

Onboarding

Once you've electronically signed your offer, our onboarding team will get you ready for Week 1 and set you up for success! Onboarding tasks may include a background check, drug screening, and other job specific requirements.

NULL ALT
NULL ALT
NULL ALT
NULL ALT

Join Our Talent Community

Receive job alerts and stay up to date with ways that Change Healthcare is transforming the healthcare industry, one innovation at a time.

Sign up to receive job alerts and the latest on Change Healthcare.

Please note that by providing your contact information, you may be contacted by one of our recruiters.

Interested InSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.

By submitting my information, I acknowledge that I consent to receive electronic communications from Change Healthcare. I understand that I can opt out from receiving those emails at any time by clicking "Unsubscribe" in any email I receive.