Healthcare Consultant II

Job is Expired

Location: Remote

Compensation: To Be Discussed

Reviewed: Fri, Mar 27, 2026

Job Category: Management

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A company is looking for a Consultant II Ideation & Analytics DRG.

Key Responsibilities

Develop and implement an effective DRG audit program, including rules for claim identification and review guidelines
Identify and create concepts for recognizing incorrect payments based on industry experience and regulatory research
Research reimbursement regulations and update audit recovery reports and custom queries

Required Qualifications

Bachelor's degree in Science, Pharmacy, or Nursing
5+ years of experience in the healthcare industry, with a focus on Payer
3+ years of experience in DRG Coding, Clinical Validation, or as a DRG Quality Auditor
1+ year of experience in research and ideation for clinical audit programs
Proficiency in MS Word, Excel, and PowerPoint is preferred

COMPLETE JOB DESCRIPTION

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Job is Expired

Company Overview

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