Senior Manager - Revenue Integrity (remote)
About The Position
Optum NY/NJ is seeking a Senior Manager Revenue Integrity to join their team. Optum is a clinician-led care organization focused on improving healthcare. As a member of the Optum Care Delivery team, you will contribute to making healthcare better for everyone. Optum provides clinical resources, data, and support from a global organization to help patients live healthier lives. The company offers an exceptional career experience, empowering employees to live their best lives at work and at home. This role offers the fulfillment of advancing community health and the excitement of contributing new practice ideas and initiatives that could improve care for millions of patients nationwide. The Senior Manager of Revenue Integrity acts as a trusted partner to the VP of Revenue Integrity, supporting coding compliance, auditing, and education. The role ensures accurate, complete, and compliant code capture for professional fee services and drives continuous improvement through coder education and audits. This position is remote for individuals located in New York.
Requirements
- Undergraduate degree or equivalent experience
- CPC, CCS, RHIA, or equivalent coding certification
- 10+ years of experience in coding, auditing, compliance, or revenue integrity
- Proven experience leading coding compliance, audit, or education programs
- Leadership experience managing teams and driving performance
- Experience with coding audits, QA programs, and compliance monitoring
- Leadership experience
- Demonstrated expertise in professional fee coding across multiple specialties
- Deep knowledge of CPT®, ICD-10-CM, HCPCS, CMS, and payer guidelines
- Solid understanding of revenue cycle operations, including charge capture and denial management
- Demonstrated ability to analyze data, identify trends, and translate findings into actionable improvements
- Proven excellent written and verbal communication skills
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Nice To Haves
- Bachelor’s degree in healthcare administration, Health Information Management, or related field preferred
Responsibilities
- Provide oversight of coding compliance, ensuring alignment with CMS, Optum, and payer-specific requirements
- Establish and maintain audit frameworks (prospective and retrospective) to monitor coding accuracy and compliance
- Identify compliance risks, escalation of high-risk findings, and collaborate across Revenue Integrity functions to mitigate identified risks
- Ensure audit methodologies, scoring, and reporting are consistent and defensible
- Maintain current knowledge of CPT, ICD-10-CM, HCPCS, CMS regulations, and payer policy updates
- Serve as a resource for coding and compliance interpretation across teams
- Translate regulatory changes into operational workflows, education, and guidance
- Lead, mentor, and develop coding, auditing, and/or education staff
- Promote a culture of accountability, collaboration, and continuous improvement
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
