Devoted Health
Payment Integrity Program Manager
$73K–$125K
Remote USA · Manager · Full-time · Posted Oct 7, 2026
- Experience
- 2–3 years required in one of the listed healthcare audit, Payment Integrity, coding review, clinical documentation review, or compliance areas.
About the job
Oversees inpatient Payment Integrity programs, performing and managing audits while ensuring quality, timeliness, compliance, and defensible outcomes.
What you'll do
- Perform complex inpatient audits, including clinical validation, DRG coding validation, readmission, and hospital bill reviews.
- Guide internal staff and vendors through calibration, training, feedback, and quality monitoring.
- Monitor program metrics, disputes, and vendor results; resolve escalations and drive improvements.
What they ask for
- 2–3 years of experience in healthcare audit, Payment Integrity, coding review, clinical documentation review, or compliance.
- Strong clinical and inpatient coding knowledge; CCS, RHIA, RHIT, RN, or equivalent inpatient coding/clinical validation experience required.
- Experience with inpatient DRG assignment and validation, including ICD-10-CM, diagnosis assignment, MCC/CC, POA indicators, documentation review, severity/risk concepts, and readmission logic.
- Experience reviewing medical records and working within structured audit programs; demonstrated training experience in Payment Integrity audits.
Nice to have
- Bachelor’s Degree.
- Demonstrated expertise in inpatient DRG coding and validation; experience managing offshore vendors; hands-on experience with AI tools, automation, or LLM-based workflows.
Pay
$73,000 - 125,000 annually (base salary)
Tools
ICD-10-CM, AI tools, automation, LLM-based workflows
AI focus
Preferred curiosity and hands-on experience using AI tools, automation, or LLM-based workflows in operational settings.
Model-written summary · the original posting is authoritative