Diagnosis-Related Group (DRG) Manager

EXL • United States,

1d • $100,000 - $120,000 • Remote

About The Position

The DRG Manager leads the planning, coordination, and execution of DRG audit activities, ensuring teams meet client SLAs and operational goals. This role oversees inventory, aging, risks, and day-to-day performance, while collaborating cross-functionally to support program success. The role directly manages a team of auditors responsible for MS-DRG and APR-DRG reviews, ensuring accurate coding and reimbursement outcomes. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in Coding Guidelines, Coding Clinic, and audit tools, and a solid understanding of CMS regulations and payer requirements.

Requirements

• Strong leadership skills
• Strong analytical skills
• Expertise in Coding Guidelines
• Expertise in Coding Clinic
• Expertise in audit tools
• Solid understanding of CMS regulations
• Solid understanding of payer requirements

Responsibilities

• Lead the planning, coordination, and execution of DRG audit activities.
• Ensure teams meet client SLAs and operational goals.
• Oversee inventory, aging, risks, and day-to-day performance.
• Collaborate cross-functionally to support program success.
• Directly manage a team of auditors responsible for MS-DRG and APR-DRG reviews.
• Ensure accurate coding and reimbursement outcomes.

Benefits

• Salary Range: $100,000 – $120,000
• 100% Remote (U.S.-based)
• Up to 10% annual travel (for team meetings and limited client onsite engagements.)

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed