Senior Manager, Content Performance – Coding Compliance

Rialtic

Senior Manager leading content performance and coding compliance at Rialtic, improving processes for a healthcare technology platform. Engaging with cross-functional teams to ensure quality and efficiency in content development.

Posted 5/14/2026full-timeRemote • 🇺🇸 United StatesSeniorWebsite

About the role

Key responsibilities & impact

Grow and lead a high-performing team of Content Policy Managers and Analysts
Serve as a player-coach, creating an environment of ownership, resilience, and high accountability — without micromanaging
Research potential policy defects and resolve inquiries submitted by clients and colleagues from across the enterprise
Troubleshoot policy defects and collaborate with Content and Engineering teams to adjust and resolve policy design to deliver the intended functionality
Lead root cause analysis (RCA) of identified policy defects to determine additional controls needed to drive E2E continuous quality improvement
Proactively leverage policy utilization trend data to monitor, investigate, and mitigate insight rate anomalies
Leverage the combined policy defect and utilization trend data to identify and develop process changes, automation/tooling enhancements, and scalable, AI-enabled approaches to drive increased efficiency and quality across the E2E Content development process
Partner with Product and Engineering teams to define and drive strategic Content platform enhancements
Maintain a strong sense of speed of play — balancing urgency with quality
Lead the ongoing maintenance of Rialtic’s policy library to ensure policies remain accurate and up-to-date with source changes
Lead the implementation of new CPT, HCPCS, and ICD-10 codes across Rialtic’s policy library
Manage Rialtic’s subscriptions to Content reference sources and serve as vendor relationship manager

Requirements

What you’ll need

Bachelor’s degree in healthcare administration, finance, or related field; Master’s degree or MBA preferred.
Minimum 5 years of experience in healthcare, preferably with at least 2-3 years in a leadership role in Payment Integrity, or Claims Operations
Experience with both payer and provider perspectives is strongly preferred.
Strong understanding of commercial, Medicare, and Medicaid claims workflows, including pre- and post-pay integrity processes.
Proficient in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II coding and their use in policy and reimbursement logic.
Knowledge of CMS, Medicaid, and ACA guidelines and how they inform content strategy and compliance.
Ability to interpret large datasets; experience collaborating with data science teams on fraud, waste, and abuse detection or pattern recognition.
Skilled in building scalable processes, identifying automation solutions, and delivering continuous quality improvements.
Understanding of how clinical content is deployed and managed within rule engines and claims editing platforms.
Experience leading small teams, mentoring talent, and delivering outcomes in high-change environments.
Comfortable operating in dynamic settings with evolving priorities and a limited predefined process.
Strong written and verbal communication skills for cross-functional collaboration and stakeholder alignment.
Comfort with modern asynchronous communication tools such as Slack, Zoom, and other documentation solutions such as Notion and Google Drive.

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

ICD-10-CMICD-10-PCSCPTHCPCS Level IIdata analysisprocess automationquality improvementclaims workflowspolicy designroot cause analysis

Soft Skills

leadershipmentoringcommunicationcollaborationproblem-solvingadaptabilityownershipresilienceaccountabilityteam management

Certifications

Bachelor’s degreeMaster’s degreeMBA