Program Management Lead, Offshore Coding Operations

Program Management Lead, Offshore Coding Operations

The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical records and ICD-9 / 10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore Coding Operations optimizes the effectiveness of the offshore coding (post-visit) team. The lead analyzes the performance of the offshore coding team and creates strategies to maximize associate output.

Relationship Building :

• Cultivate relationships with onshore and offshore coding teams including leaders.
• Serve as liaison and primary point of contact with the offshore (vendor) leaders.
• Strategy :
• Advises coding leaders to develop functional strategies (often segment specific) on matters of significance.
• In partnership with Operational Excellence and Divisional Coding Leaders, develop strategies for continuous improvement of offshore coding processes and quality.
• Post-Visit / Offshore Coding Collaboration :
• Partner with analytics to develop quality assurance program on post-visit reviews. (Frequency and sampling methodology to be determined).

Qualitative and Quantitative Analyses :

Mergers and Acquisitions :

Proposed Requirements :

Preferred Qualifications :

Knowledge, Skills, and Abilities :

Additional Information :

Work at Home Requirements :

To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria :

Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours : 40

Pay Range : $104,000 - $143,000 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits : Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline : 11-14-2025

About Us

About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.

About CenterWell, a Humana company : CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer : It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.