Director of DRG Validation

Job Summary

Leading the development and launch of a new service offering, the full-time remote Director of DRG Validation will manage the operational model, workflows, and performance standards for DRG validation, while collaborating with cross-functional teams to enhance service delivery and drive market strategy.

Key responsibilities

• Define and implement the operating model, workflows, and quality standards for the DRG validation service line
• Provide subject matter expertise in DRG validation, including coding and revenue integrity, to support scalable technology solutions
• Establish performance metrics and advise on pricing models and sales strategies for the DRG offering

Required qualifications

• Deep expertise in Diagnosis-Related Group Validation (DRGV) and hands-on coding experience
• Expert-level knowledge of Medicare Severity Diagnosis-Related Group (MS-DRG) classification and reimbursement methodology
• Experience designing and leading DRGV programs, including operational workflows and productivity metrics
• Strong understanding of revenue cycle processes and clinical documentation integrity
• Proven ability to lead cross-functional initiatives and influence stakeholders across technical and operational teams