Rialtic
We are on a mission to make healthcare more efficient.
Payment Accuracy Policy Manager, Drugs
Location
United States
Posted
42 days ago
Salary
Not specified
English
Job Description
• Review healthcare policies and determine the logics to create based on strategic and technical considerations
• Create functional designs and test claims from concept through validation and maintenance
• Review, edit and finalize designs and test claims assigned to content analysts
• Mentor and coach content analysts on conceptualizing, creating and delivering claims processing edits
• Create and manage special projects and programs from concept through execution and maintenance
• Troubleshoot edits that do not function as expected and collaborate with Engineering teams
• Drive prioritization of drug library
• Curating drug edit scoping templates
• Partnering with our clinical teams to review & respond to Validation questions
• Identify and create business cases for any system enhancements
• Partner with our Clinical Leadership on providing content development & maintenance
Job Requirements
- RN or Pharmacist required
- Project Management experience
- Payment Integrity experience
- Oncology experience preferred
- Drug dosing calculation experience
- Experience using Google product suite, including Google sheets preferred
Benefits
- Freedom to work from wherever you work best and a home office stipend to make it happen
- Meaningful equity and 401 (k) matching
- Flexible, Open PTO Plan
- Wellness Stipend
- Comprehensive health plans with generous contributions to premiums
- Mental and physical wellness support through TalkSpace, Teladoc and One Medical subscriptions
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