Content Policy Manager

Summary

Join Rialtic, a healthcare technology company, and contribute to transforming the healthcare system by reducing administrative costs and improving efficiency. This client-facing role involves driving the adoption of payment integrity policies, analyzing claims data, and simplifying complex medical coding and policy recommendations. You will work with clients to implement policies, present findings, and collaborate with stakeholders. The ideal candidate possesses strong communication skills, expertise in claims analysis and analytics, and experience in payment integrity within a health plan or claims editing vendor. Rialtic offers a remote-friendly work environment, competitive benefits, and a commitment to a diverse and inclusive workplace.

Requirements

• 3-6 years of work experience in payment integrity with a health plan or claims editing vendor
• Coding, Billing, and/or Auditing Credentials or any certified coding specialty
• Advanced Google Suite skills
• Deep knowledge of claims edits’ top error reasons, client value, and analytics
• Expert in interpreting medical policies and applying correct coding guidelines
• Expertise in multiple medical coding and/or billing specialties
• Expertise in professional and institutional claims
• Experience explaining medical policies and payment accuracy to clients
• Managed claims editing implementations
• Strong verbal communication skills
• Experience presenting on client calls, answering client questions, and negotiating client requests with internal resources

Responsibilities

• Understand how to interpret healthcare correct coding policies and claims edits
• Explain healthcare policy edits to clients
• Increase policy adoption and drive savings rates per client
• Use data to make policy review recommendations
• Oversee policy implementation including prioritizing policies to present
• Attend client implementation meetings and serve as primary content spokesperson, point of contact, and coordinator to external and internal departments on client account(s)
• Develop timelines for client creation requests and influence teams to meet deliverables
• Ensure client policy requests are understood, addressed, and executed as determined
• Know and report on client implementation and decision making trends
• Analyze clients’ adoption trends and compare to proof of concept results. Explore findings with clients
• Be accountable for gathering, updating, and explaining content policy review materials
• Establish a process and methodology to prioritize policies to create based on savings

Benefits

• Freedom to work from wherever you work best and a home office stipend to make it happen
• Meaningful equity and 401k matching
• Unlimited PTO and wellness reimbursements
• Comprehensive health plans with generous contribution to premiums
• Mental and physical wellness support through TalkSpace, Teladoc, and One Medical subscriptions