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Job DescriptionSalary: About Plutus Health Inc.: Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services, certified in SOC2 compliance and recognized among the Inc. 5000 fastest-growing private companies. We specialize in revenue cycle optimization for hospitals, physician groups, and healthcare organizations across various specialties. Our commitment to innovation and excellence has earned us recognition as a 2024 EY Entrepreneur Of The Year finalist and one of the top 100 fastest-growing companies in Dallas. Job Description: We are seeking an experienced Client Success/ Coding Manager with expertise in medical coding, auditing, and compliance to oversee client relationships, coding operations, and revenue cycle optimization. This role requires a deep understanding of CPT, ICD-10, HCPCS, payer policies, and denial management, ensuring that clients receive best-in-class coding services and compliance support. The ideal candidate will have a strong background in medical coding, compliance audits, RCM workflow optimization, and payer regulations, along with exceptional client relationship management skills. Key Responsibilities: Client Success & Relationship Management: • Serve as the primary point of contact for clients, ensuring smooth communication and resolution of coding-related concerns., • Develop and implement client engagement strategies to maximize satisfaction, retention, and revenue growth., • Conduct Quarterly Business Reviews (QBRs) and compliance audits to drive process improvements., • Identify upsell and cross-sell opportunities within client accounts to expand coding service offerings. Medical Coding & Compliance Oversight: • Ensure adherence to ICD-10, CPT, HCPCS, and payer-specific guidelines across multiple specialties., • Conduct coding audits, documentation reviews, and risk assessments to improve coding accuracy and compliance., • Monitor denial trends, coding discrepancies, and revenue leakage, implementing corrective actions as needed., • Stay up to date with Medicare, Medicaid, and commercial payer regulations, ensuring regulatory compliance., • Provide training and education to clients and internal teams on evolving coding guidelines and best practices. Revenue Cycle & Denial Management: • Optimize coding workflows, ensuring efficient charge capture and clean claim submission., • Collaborate with billing, AR, and denial management teams to reduce denials, enhance revenue recovery, and improve coding accuracy., • Track key performance indicators (KPIs) such as clean claim rates, denial rates, coding accuracy, and compliance scores., • Drive coding automation initiatives to improve operational efficiency and minimize manual errors. Cross-Functional Collaboration & Leadership: • Work closely with operations, compliance, and technology teams to refine and enhance coding service offerings., • Lead and mentor onshore and offshore coding teams, ensuring high performance and adherence to compliance standards., • Partner with business development teams to support client onboarding, process improvement initiatives, and contract renewals., • Act as an RCM Subject Matter Expert (SME) in internal strategy discussions and client engagements. Required Qualifications: • Bachelors degree in Healthcare Administration, Business, or a related field (Masters preferred)., • 7+ years of experience in medical coding, auditing, and revenue cycle management in a leadership role., • Certification required: CPC, CCS, or equivalent (AHIMA or AAPC certification preferred)., • Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies., • Experience in coding audits, denial resolution, and revenue integrity initiatives., • Proficiency in RCM platforms, EHR/EMR systems (Epic, Meditech, Paragon, etc.)., • Experience managing onshore/offshore coding teams and handling multi-client engagements., • Strong analytical, problem-solving, and negotiation skills with the ability to translate data into actionable insights., • Willingness to travel as needed. Why Join Plutus Health Inc.? • Work for a fast-growing, innovative company recognized for excellence in healthcare., • Collaborate with a dynamic, supportive team that values professional development., • Make a meaningful impact on patient care and operational success.

Job Description Hi, we're Oscar. We're hiring a Senior Project Manager to join our Network Operations Governance & Oversight team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Project Manager manages, maintains and oversees significant projects and initiatives in support of Network Contracting and Provider Operations functions at Oscar. This role drives end-to-end operational excellence by working cross functionally to ensure effective communication and process execution, supports technology and tool development from a business perspective, and contributes to all contracting efforts. You will report into the Director, Network Ops Governance & Oversight Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $118,080 - $154,980 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: • Using a cross-functional lens and subject matter expertise, drive end-to-end operational excellence, measuring, monitoring, and executing to reduce operational, financial, compliance and regulatory risks and to ensure efficient, repeatable processes leading to a sound program., • Manage large, multiple cross-functional work groups that support and optimize end-to-end Network Contracting processes, • Lead, oversee, and coordinate projects, products, and strategic initiatives related to network contracting. This includes establishing governance programs, supporting the development of technical tools, and maintaining the provider manual., • Leverage subject matter expertise to drive targeted program standardization, operationalization, and issue resolution and/or root cause analysis efforts while collaborating with key internal stakeholders to optimize efficiency, including training resources and other key process decisions, • Develop, present, and maintain executive reporting materials to educate, inform, and update senior leadership teams on programs, projects, and strategic contracting initiatives, • Develop subject matter expertise in methodologies, major terms, and associated operations required for program execution, • Identify risks and improvement opportunities to develop and implement new programs, • Compliance with all applicable laws and regulations, • Bachelor's Degree or 4+ years of commensurate experience, • 6+ years of program and project management in the health insurance space, • 6+ years experience in network contracting or provider relations/provider operations space, • Experience working within a rapidly scaling organization, • BA/BS Degree At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description Hi, we're Oscar. We're hiring a Senior Project Manager to join our Network Operations team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Project Manager is a key leadership role responsible for driving end-to-end operational excellence by managing, maintaining, and overseeing significant projects and strategic initiatives across the company. This individual leverages subject matter expertise and a cross-functional lens to lead and coordinate multiple large work groups, ensuring efficient, repeatable processes that reduce operational, financial, compliance, and regulatory risks, resulting in a sound program. A core responsibility is leading efforts in program standardization, operationalization, and issue resolution, including root cause analysis, while developing, presenting, and maintaining executive reporting materials to keep senior leadership informed. Furthermore, the Senior Project Manager identifies risks, drives improvement opportunities for new programs, maintains compliance with all applicable laws and regulations, and organizes critical program documentation like meeting notes and decisions. You will report into the Director, Process Improvement. Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $118,080 - $154,980 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Using a cross-functional lens and subject matter expertise, drive end-to-end operational excellence, measuring, monitoring, and executing to reduce operational, financial, compliance and regulatory risks and to ensure efficient, repeatable processes leading to a sound program., • Manage large, multiple cross-functional work groups that support and optimize end-to-end program process while improving visibility into internal processes, • Lead, oversee, and coordinate the various projects, products and strategic initiatives, • Leverage subject matter expertise to drive targeted program standardization, operationalization, and issue resolution and/or root cause analysis efforts while collaborating with key internal stakeholders to optimize efficiency, including training resources and other key process decisions, • Develop, present, and maintain executive reporting materials to educate, inform, and update senior leadership teams on programs, projects, and strategic contracting initiatives, • Develop subject matter expertise in methodologies, major terms, and associated operations required for program execution, • Identify risks and improvement opportunities to develop and implement new programs, • Organize and catalog meeting notes, action items, decisions made, and follow-ups in leadership meetings, or as needed, • Other contracting and operational implementation as assigned, • Compliance with all applicable laws and regulations, • Bachelor's Degree or 4+ years of commensurate experience, • 6+ years of program and project management in the healthcare space, • 6+ years experience in change management and process improvement and implementation, • Experience working within a rapidly scaling organization, • Masters in Business Administration or healthcare related field(s) At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.