Cotiviti · 18 hours ago
Senior Manager, Audit Operations (CCV)
United States
Full-time
Remote
Mid, Senior Level
$120K/yr - $145K/yr
5+ years expCotiviti is a healthcare analytics company, and they are seeking a Senior Manager for Audit Operations to lead the Clinical Chart Validation audit team. This role involves overseeing audit performance, managing process improvements, and ensuring compliance with client SLAs and budget commitments.
Information Technology & Services
Responsibilities
Accountable for overseeing process improvement strategic initiatives that primarily lead to measurable audit efficiencies and cost savings; with associated increased revenue
Works closely with Audit Leadership colleagues and personnel to continuously identify improvement opportunities, formulate improvement plans, and facilitate the execution of such plans
Oversees the Natural Language Processing program ensuring value is optimized through NLP rule and UI optimization, auditor proficiency with the tool, and vendor collaboration
Leads vendor management oversight and serves as the contractual liaison for software support
Provides day-to-day supervision and direction to assigned audit Team Leads. Ensures operations are running optimally and processes and procedures are being followed
Ensures appropriate staffing levels and plans and organizes workloads and staff assignments according to the needs of the audit. Manages the overall performance, productivity, and quality of the assigned audit teams. Maximizes opportunities of the audit; optimizes timely audit processes and efficiencies
Involved in formulating all budget related aspects of the audit. Executes and adjusts to budget demands. Drives the profitability of the audit engagement
Consistent with good people management practices and company values, providing managerial leadership and directing the selection, supervision, evaluation, and development of staff. Set objectives and conduct performance reviews for direct reports and oversee the remaining evaluations for indirect team members
Work with Human Resources to recommend and implement performance management, progression, and compensation actions as warranted. Resolve employee concerns and other sensitive people issues consistent with Human Resources policies and guidelines
Follow established processes for training and career progression to enable revenue growth and auditor and support staff development and engagement. Promote & participate in knowledge sharing activities such as best practices, benchmarking, whitepapers, and IT tools enhancement. Ensure that all levels of staff are properly trained on policies, procedures and best practices and that proper training, education and required certifications are maintained as required
Innate ability to share knowledge and develop audit skills in others. Broadly fosters formal and informal knowledge sharing activities
Assigns proportionate workload to team that yields maximum productivity and achievable, profitable results
Always goes over and above what is expected in seeking and sharing ideas in a positive and productive way. Considered go to person for root cause process improvements. Capitalizes on audit resources to extend current or business capabilities, ensuring that client demands are met in the short and long term
Treats customers/clients both internal and external as number one priority, is committed to continuous quality improvement, is courteous and responsive to customer's needs, meets or exceeds all customer commitments and treats customers honestly
Direct accountability for overall Quality Control Process within the audit. Demonstrates advanced expertise and comprehension (knowledge) of claim categories, claim types. Holds the Audit team accountable for ensuring submission and execution of quality work, proper use of available proprietary software, reports, and IT resources to conduct audits
Demonstrates understanding of Cotiviti policies & procedures Assures confidentiality and security of all data. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards
Maintains strict adherence to organizational values for both Cotiviti and client
Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction
Complete all responsibilities as outlined on annual Performance Plan
Complete all special projects and other duties as assigned
Must be able to perform duties with or without reasonable accommodation
Qualification
Required
Bachelor's degree is required
RN license and/or Coding Certification is required
At least 5-7 years of management experience required; people management experience is required
Proven ability to successfully manage a team and collaborate with others
Excellent verbal and written communication skills required
Advanced computer skills in Excel and Access required
Manage multiple client deliverables and competing deadlines simultaneously
Experience in working directly with clients to communicate production and quality accuracy details
Awareness and adherence to HIPAA privacy and security regulations
Preferred
Prefer 5+ years of related audit experience
Strong working knowledge and understanding of clinical and coding audits
Benefits
Medical
Dental
Vision
Disability
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
Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States.
5001-10000 employees
H1B Sponsorship
Cotiviti has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (165)
2024 (118)
2023 (90)
2022 (102)
2021 (72)
2020 (67)
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
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