Machinify

4 months ago

DRG Manager

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 3 hours agoStatus: Live

Job Summary

Lead the development and management of our clinical DRG solutions, driving accuracy in MS and APR-DRG validation, regulatory compliance, and client-focused outcomes. Manage a DRG team, oversee claims review processes, and collaborate with product, analytics, and sales to optimize coding, reimbursement, and operational performance within a digital-first healthcare platform.

Location: United States

Workplace: Remote

Employment Type: Full time

Job Function: Business Development & Partnerships

Seniority: Manager level

Key Responsibilities

•Oversee the DRG team and provide guidance, development plans, and retention strategies for staff.
•Drive enhancement and review of clinical solutions such as readmissions and place of service.
•Monitor regulatory updates and adjust written rules to maintain compliance and effectiveness.
•Collaborate with a multi-disciplinary team to translate DRG ideas into implemented processes and solutions.
•Provide performance reporting on KPIs, quality scores, workflows, and inventory, and manage timelines and roadblocks.

Pay and Benefits

Salary: USD 125,000 - 140,000 annually

Perks:Health InsuranceDentalVision401kRemote WorkPaid Leave

Key Requirements

•Bachelor’s degree (health administration, business, nursing)
•5+ years in healthcare billing and coding
•3+ years in claims auditing and recovery auditing
•Proven experience collaborating with sales, marketing, and development teams
•Expert knowledge of MSDRG, APR DRG, AP DRG, and outpatient payment systems (APCs, EAPGs)

Experience:5+ yearsHealthcare

Education:Bachelor's

Skills:LeadershipAnalyticalCommunicationProblem-solving

Languages:English

Tech Stack:MSDRGAPR-DRGAP-DRGAPCEAPGsMedical codingCoding rulesMedicare rules

Company Brief

Machinify

Industry: Industrial Automation

Website

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Machinify

4 months ago

DRG Manager

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 3 hours agoStatus: Live

Job Summary

Location: United States

Workplace: Remote

Employment Type: Full time

Job Function: Business Development & Partnerships

Seniority: Manager level

Key Responsibilities

•Oversee the DRG team and provide guidance, development plans, and retention strategies for staff.
•Drive enhancement and review of clinical solutions such as readmissions and place of service.
•Monitor regulatory updates and adjust written rules to maintain compliance and effectiveness.
•Collaborate with a multi-disciplinary team to translate DRG ideas into implemented processes and solutions.
•Provide performance reporting on KPIs, quality scores, workflows, and inventory, and manage timelines and roadblocks.

Pay and Benefits

Salary: USD 125,000 - 140,000 annually

Perks:Health InsuranceDentalVision401kRemote WorkPaid Leave

Key Requirements

•Bachelor’s degree (health administration, business, nursing)
•5+ years in healthcare billing and coding
•3+ years in claims auditing and recovery auditing
•Proven experience collaborating with sales, marketing, and development teams
•Expert knowledge of MSDRG, APR DRG, AP DRG, and outpatient payment systems (APCs, EAPGs)

Experience:5+ yearsHealthcare

Education:Bachelor's

Skills:LeadershipAnalyticalCommunicationProblem-solving

Languages:English

Tech Stack:MSDRGAPR-DRGAP-DRGAPCEAPGsMedical codingCoding rulesMedicare rules

Company Brief

Machinify

Industry: Industrial Automation

Website