Payment Integrity Clinical Readmission Manager
Remote USARemote (US)manager$73K – $125K
Posted 2w ago · via Workday
About this role
Job Description A bit about this role: The Clinical Readmission Manager is responsible for conducting prepayment and post-payment clinical reviews of inpatient hospital admissions and subsequent admissions to the same or a related hospital within 30 days of the prior discharge date. The auditor reviews claims and medical records for both admissions to determine whether the readmission is clinically related to the prior admission and/or potentially preventable under applicable organizational, regulatory, and Payment Integrity guidelines. This role requires strong inpatient clinical knowledge, sound clinical judgment, and experience reviewing hospital records and readmission cases.…
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reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
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2
Level fit
This role is manager-level. We check your trajectory against it.
3
Domain experience
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4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible. We factor in your stated location and time-zone overlap.
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