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UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Senior Manager - Revenue Integrity
Location
United States
Posted
5 days ago
Salary
$91.7K - $163.7K / year
Seniority
Lead
No structured requirement data.
Job Description
Senior Manager - Revenue Integrity
UnitedHealth Group
Role Description Optum NY/NJ is seeking a Senior Manager Revenue Integrity to join our team in Middletown, NY. The Senior Manager of Revenue Integrity serves as a trusted partner to the VP of Revenue Integrity, providing support across coding compliance, auditing, and education functions. This role is responsible for ensuring accurate, complete, and compliant code capture for professional fee services while driving continuous improvement through coder education and audits. If you are located in New York, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: - Coding Compliance & Program Oversight: - Provide oversight of coding compliance, ensuring alignment with CMS, Optum, and payer-specific requirements. - Establish and maintain audit frameworks (prospective and retrospective) to monitor coding accuracy and compliance. - Identify compliance risks, escalation of high-risk findings, and collaborate across Revenue Integrity functions to mitigate identified risks. - Ensure audit methodologies, scoring, and reporting are consistent and defensible. - Coding & Regulatory Expertise: - Maintain current knowledge of CPT, ICD-10-CM, HCPCS, CMS regulations, and payer policy updates. - Serve as a resource for coding and compliance interpretation across teams. - Translate regulatory changes into operational workflows, education, and guidance. - Team Leadership & Development: - Lead, mentor, and develop coding, auditing, and/or education staff. - Promote a culture of accountability, collaboration, and continuous improvement. Qualifications - Undergraduate degree or equivalent experience. - Bachelor’s degree in healthcare administration, Health Information Management, or related field preferred. - CPC, CCS, RHIA, or equivalent coding certification. - 10+ years of experience in coding, auditing, compliance, or revenue integrity. - Proven experience leading coding compliance, audit, or education programs. - Leadership experience managing teams and driving performance. - Experience with coding audits, QA programs, and compliance monitoring. - Demonstrated expertise in professional fee coding across multiple specialties. - Deep knowledge of CPT®, ICD-10-CM, HCPCS, CMS, and payer guidelines. - Solid understanding of revenue cycle operations, including charge capture and denial management. - Demonstrated ability to analyze data, identify trends, and translate findings into actionable improvements. - Proven excellent written and verbal communication skills. Requirements - *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). - Salary range: $91,700 - $163,700 annually based on full-time employment.
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Senior Payment Manager
appflameFlame up the world with Ukrainian products. We create life-changing products breaking the rules of the game.
Role Description Your project: Hily. It is a dating app that allows users to be truly themselves and enjoy dating as they are. On Hily, users become part of a community where people find genuine connections and meaningful relationships. The app ranks among the Top 5 dating apps in the U.S. by downloads, competing with market leaders such as Tinder and Bumble. Hily today: - 40M users - 1.5B likes sent - 50M+ matches annually You will: - Build and optimize payment routing across PSPs/MIDs and test scenarios (fallback, cascading, smart routing) across main products. - Raise approval rate across all geos and products, and scale billing to handle new volume. - Find LTV growth points through billing: billing models, retry logic, pricing, etc. - Analyze cohorts and the impact of billing on retention. - Launch and manage MIDs, and build the legal entity structure for different products and geos. - Work with descriptors, MCC, and risk profiles, and manage relationships with providers, acquirers, and banks. - Connect billing to new products and funnels, and quickly spin up new MIDs to support scaling. - Set up payments for different business models (subscription/one-off/hybrid). - Control key metrics (approval rate, chargeback rate, refund rate, VAMP/fraud indicators) and build an alerting system. - Reduce chargebacks and fraud without losing revenue. - Run billing projects end-to-end and sync with marketing, product, and finance. - Prioritize the work that delivers business results. Qualifications - 3+ years in a similar role in a subscription business. - Hands-on experience with payment systems and payment orchestration platforms. - Solid understanding of subscription economics and how to work with LTV. - Experience with MIDs, billing models, and antifraud. - Strong billing analytics: metrics, cohorts, and impact on LTV/retention, plus full-cycle chargeback and dispute management experience (alerts, reason codes, scheme programs). - Data-driven decision-making and ability to balance revenue growth against risk. - High ownership and proactivity — sees opportunities and acts, does not wait for tasks. - English at Upper-Intermediate or higher. Requirements - Hands-on rule-setting in antifraud tools. - Knowledge of card-scheme dispute programs (Visa VDMP/VFMP, Mastercard ECM). - Comfort with BI tools (Tableau, Superset, Looker) and writing technical requirements for developers. - Experience running A/B tests. - Effective use of AI tools in day-to-day work. Benefits - Remote-first setup, modern offices with activities, and all the equipment you need, plus compensation to set up your remote workplace. - Fair pay with regular reviews; after probation, compensation for education and English courses, Online Speaking Club, online library, and course access. - Medical insurance coverage, psychologist consultations, unlimited paid sick days, and 31 paid vacation days/year (incl. public holidays). - Corporate events, team-building activities, and paid participation in sports competitions.
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SailPoint Problem Manager – Pharma
Ambit IberiaExperts in digital solutions and regulatory and quality consulting services for the Life Sciences sector
• Own and drive Problem Management activities for the SailPoint IdentityIQ platform, ensuring timely identification and resolution of recurring issues. • Perform in-depth Root Cause Analysis (RCA) for complex incidents and implement sustainable corrective actions. • Investigate and resolve issues related to identity lifecycle processes, provisioning, workflows, certifications, roles, entitlements, and integrations. • Analyze application logs, database records, scheduled tasks, and system processes to identify root causes and performance bottlenecks. • Troubleshoot and optimize platform stability, performance, data quality, and operational reliability. • Collaborate with SailPoint L3 Support, application owners, infrastructure teams, and external vendors to resolve technical issues. • Support continuous improvement initiatives to reduce incident recurrence and improve service resilience. • Maintain technical documentation, knowledge articles, and operational procedures. • Contribute to change, release, and operational activities under the guidance of the System Lead.
