[Remote] Project Manager CCV (Outpatient Specialty)

Note: The job is a remote job and is open to candidates in USA. Cotiviti is a healthcare analytics company, and they are seeking a Project Manager for their Outpatient Specialty division. This role involves aligning policies across Commercial and Government clients, analyzing data for process improvements, and managing project documents and presentations.

Responsibilities

• Ensure consistent application of OPSP policies across both Commercial and Government clients by collaborating with key areas such as Content, Training and Appeals. This includes addressing new policy changes identified during the CMS Q6 process or QA/Appeals feedback
• Utilize project management skills to develop and manage project documents and presentations using tools like Excel, Visio, and PowerPoint
• Create and maintain project status documents and conduct regular status meetings to keep projects on track. Foster efficient teamwork, track lessons learned and share insights with team members
• Perform analysis and monitoring of various Key Performance Indicator (KPI) reports to drive continuous improvement
• Recommend and track system or process improvements to boost productivity, quality or cost containment
• Monitor system issues for IT escalation. Analyze trends and root causes of issues and downtime to identify areas of process improvement
• Assisting in ensuring operational controls are in place to meet client budget goals. Monitor selections to promptly identify staffing and training needs, ensuring timely completion of claims
• Complete all special projects and responsibilities as outlined in the annual performance review and/or goal setting
• Complete all responsibilities as outlined in the annual performance review and/or goal setting
• Complete all special projects and other duties as assigned
• Must be able to perform duties with or without reasonable accommodation

Skills

• Bachelor's degree in Health Information Management or nursing (with active / unrestricted) license
• Coding or Clinical Documentation Certification required i.e. CCDS, CPC, CIC, CCS, RHIA or RHIT (those without a coding certification will be asked to achieve one)
• 5+ years of related experience in a healthcare billing office or claims management role Related to the following areas: DRG Validation (MS, AP, or APR DRGs), APC/ASC Validation, Outpatient Review Types (Procedural Services, Physician Services, Emergency Department, Diagnostics and/or Laboratory Services)
• Requires working knowledge of and applicable industry-based standards
• Ability to work well in an individual and team environment
• Strong written and verbal communication skills with excellent interpersonal skills
• Computer proficiency in Microsoft Excel, Access, Visio, PowerPoint and system databases are required
• Experience managing project life cycle from initial proof of concept through approval, development, delivery, and implementation
• Ability to build relationships across teams and other departments to facilitate successful delivery of projects
• Prior Healthcare Billing and/or claims experience desired but not required

Benefits

• Medical, dental, vision, disability, and life insurance coverage
• 401(k) savings plans
• Paid family leave
• 9 paid holidays per year
• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti

Company Overview

Company H1B Sponsorship