Description Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Health Plan is calling a Manager Coding Policy who will: Be responsible for the management and supervision of all Coding Policy development, quality, implementation, publication, and interim or routine update Coordinate, manage, and direct all aspects of the Plan's policy life cycle Ensure all coding, regulatory, legal, and operational practices are maintained, consistent, and documented Manage certified Coding Policy Analysts and all coding-related reviews, work queues, and analyst metrics Ensure appropriate review and payment of coding related claims in a timely fashion across all lines of business Be responsible for identification and operationalization of new coding review initiatives, driving toward new opportunities to implement appropriate coding UM controls Be responsible for building and maintaining strategic internal and external relationships as they relate to the administration and operationalization of coding policies for all lines of business, clients, and business partners Be responsible for complex projects, including oversight of the coding policy edits in the claim editing system to ensure consistent and accurate adjudication of claims Represent the Coding Policy Team and related work in high-profile leadership meetings, ensuring thorough communication of policy changes and related impacts, including data analysis, to internal and external stakeholders Be responsible for creating and maintaining strategic partnerships and using superior leadership and management skills to translate related policy changes to meet Plan department and team needs Be responsible for ensuring all Coding Policy changes and updates are vetted through appropriate review structure and committee meetings prior to implementation Be responsible for routine presentations regarding all financial business opportunities and strategic process improvements which result in team growth, savings, and quality Be responsible for setting Coding Policy Team strategic goals, ensuring team collaboration, and provide coaching and mentorship to ensure alignment with Department and Plan vision and mission We welcome 100% remote work for residents who reside in one of the following States: Alaska Washington Oregon Montana California Nevada New Mexico Texas Required qualifications for this position include: Bachelor's Degree in Business Administration, Healthcare Administration, or a closely related field of study Certified Professional Coders Certificate 5+ years of related experience working in or with a managed care or health care organization 5+ years of Clinical Coding experience, preferable in a payer setting 3+ years of experience with CMS, Medicaid and State(s) regulatory requirements and quality accreditation bodies - NCQA and/or URAC 5+ years of leadership experience 3+ years of experience in technical policy & procedure writing as it relates to regulatory and accreditation standards Preferred qualifications for this position include: Master's Degree in Healthcare Administration, Public Health, Business Administration or related field Coursework/Training: Training in one or more of the following: Lean, Agile, six Sigma and Change Acceleration Process (CAP) Internal auditing & monitoring principles Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achi