Medical Policy Release Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the release of medical policies, their schedules, and updates related to IT systems.

• Create and manage calendars for medical policy revisions and software updates.

• Facilitate collaboration across various teams to address dependencies.

• Ensure that policy and technical releases adhere to CMS, federal, state, and regulatory standards.

• Act as a liaison between Clinical Policy teams, IT, and Business Operations.

• Provide updates on release status, risks, and timelines.

• Drive go/no-go decisions and verify user acceptance testing.

• Develop rollback strategies for potential deployment failures.

• Manage tickets and share data-file statuses in release notes.

• Confirm policy and code modifications across content management platforms.

• Identify risks and resolve issues impacting release scope, timeline, and quality.

• Plan and coordinate releases across development, QA, and production environments.

• Guarantee risk assessment, prioritization, approvals, and documentation of changes.

• Serve as a gatekeeper for the accuracy of policies.

• Assist client teams with PURs and other eLL inquiries.

• Engage in eLL application upgrades or functionality modifications.

• Recruit, develop, mentor, lead, and retain team talent.

• Fulfill performance-plan responsibilities and special projects.

⛳️ Requirements

• Minimum of 6 years of experience in coding related to healthcare policy, billing and coding software, regulatory analysis, or IT release management.

• A degree and professional certification (AHIMA or AAPC) is preferred.

• Knowledge of ITIL frameworks is desired.

• Experience with change management tools like Jira and ServiceNow.

• Proven ability in planning, scheduling, and coordinating releases across development, QA, and production environments.

• Competence in risk assessment, prioritization, approvals, and change documentation.

• Capability to interpret rule descriptions, scripts, and temporary regulations.

• Experience in validating policy and code changes within content management systems.

• Strong analytical and comparative skills for multi-tab validation.

• Familiarity with researching CPT, HCPCS, ICD, or NDC codes.

• Understanding of claims payment and reimbursement practices.

• Ability to analyze data and make informed, data-driven decisions.

• Proficient in managing timelines and multiple projects with exceptional accuracy and attention to detail.

• Strong analytical, critical-thinking, and problem-solving abilities.

• Proficiency in Microsoft Office Suite.

• Preferred knowledge of Excel, including pivot tables and functions.

• Excellent interpersonal, verbal, and written communication skills.

• Work-from-home setup with high-speed internet required.

• Flexibility to join conference calls across various global time zones.

• Willingness to work occasional after-hours and weekends to meet major deadlines.

• Capability to maintain a dedicated and secure work environment.

• Ability to ensure high-speed internet access and maintain an office setup.

• Capacity to perform duties with or without reasonable accommodations.

• Understanding of Cotiviti's policies, procedures, information security, and regulatory compliance.

• Commitment to maintaining confidentiality and data security.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Disability insurance.

• Life insurance coverage.

• 401(k) savings plan.

• Paid family leave.

• 9 paid holidays per year.

• 17–27 days of Paid Time Off (PTO) annually, based on specific level and length of service.

• High-speed internet and other necessary tools provided.

• Commitment to equal employment opportunities.