California Licensed DRG Validation Director

Job Summary

A company is looking for a DRG Clinical Validation Director responsible for developing and managing clinical validation solutions.

Key Responsibilities

• Develop and execute strategic plans for the DRG clinical validation program
• Lead and manage the DRG Clinical Validation team, ensuring optimal performance and professional growth
• Oversee the clinical claims review process and maintain quality assurance standards

Required Qualifications

• Bachelor's degree in health administration, business, or nursing
• 5+ years of experience in healthcare billing and coding
• 3+ years of experience in claims auditing and recovery auditing
• Nursing license and certifications of CCDS or CDIP required
• Previous supervisory experience is required