Payment Integrity Content Portfolio Manager, Drugs and Biologicals

📌 Core Information

🔹 Job Title: Payment Integrity Content Portfolio Manager, Drugs and Biologicals

🔹 Company: Rialtic, Inc.

🔹 Location: Atlanta, Georgia, United States

🔹 Job Type: Remote

🔹 Category: Not Specified

🔹 Date Posted: March 31, 2025

🔹 Experience Level: 5-10 years

🔹 Remote Status: Remote

📌 Essential Job Details

🚀 Job Overview

Key aspects of this role include:

• Leading the management of the FDA Drugs and Biologicals portfolio
• Providing data-driven insights for healthcare technology advancement
• Working within the Content Creation pod at Rialtic
• Collaborating with both onshore and offshore resources

ASSUMPTION: The position emphasizes content management with a strategic focus on improving healthcare technology through effective use of data insights, which aligns with Rialtic's mission to enhance healthcare efficiency.

📋 Key Responsibilities

✅ Manage the FDA Drugs and Biologicals portfolio including scoping, design, and QC

✅ Develop and maintain professional edits for drugs and biologicals

✅ Educate and mentor content analysts

✅ Develop timelines and manage teams to meet deliverables

✅ Explain policy edits to clients and ensure policy requests are executed properly

✅ Increase policy adoption and drive savings rates

✅ Review sources like Medicare, Medicaid, and FDA for correct coding edits

✅ Manage special projects from concept to execution

✅ Provide expertise to inform the prioritization and roadmap of edits

✅ Validate edits with claims data and troubleshoot unexpected issues

ASSUMPTION: The responsibilities indicate a blend of hands-on coding work and management duties, highlighting the need for a strategic vision and operational excellence.

🎯 Required Qualifications

Education: Medical coding certification from AAPC, AHIMA, or equivalent degree

Experience: 4-6 years in payment integrity with a focus on drugs and biologicals

Required Skills:

• Expertise in interpreting FDA drug labels
• Strong understanding of claims editing processes
• Advanced skills in Google Suite
• Excellent verbal communication and negotiation skills

Preferred Skills:

• Experience with National Drug Code data
• Background in managing claims editing implementations

ASSUMPTION: Required qualifications emphasize a strong foundation in medical coding and effective communication with clients and team members.

💰 Compensation & Benefits

Salary Range: Not specified

Benefits:

• Freedom to work remotely with home office stipend
• Meaningful equity and 401k matching
• Unlimited PTO and wellness reimbursements
• Comprehensive health plans with generous premium contributions
• Mental and physical wellness support through TalkSpace, Teladoc, and One Medical

Working Hours: Requires working EST hours

ASSUMPTION: Although salary is not specified, benefits indicate a comprehensive employee package, reflecting the value placed on work-life balance and employee well-being.

📌 Applicant Insights

🔍 Company Context

Industry: Hospitals and Health Care

Company Size: 51-200 employees, offering a dynamic environment with substantial opportunities for impact

Founded: 2020

Company Description:

• Focused on creating efficiencies in healthcare technology
• Backed by seasoned industry veterans and tech experts
• Committed to reducing administrative burdens in healthcare

Company Specialties:

• Economic efficiencies in healthcare
• Healthcare technology innovation
• Adjudication of healthcare claims

Company Website: http://rialtic.io

ASSUMPTION: Rialtic's positioning as a technology innovator in healthcare suggests a focus on cutting-edge solutions and ongoing development.

📊 Role Analysis

Career Level: Mid to senior level requiring expertise in the healthcare coding domain

Reporting Structure: Likely reports to the head of the Content Department

Work Arrangement: Full-time, remote with EST working hours

Growth Opportunities:

• Career advancement in healthcare technology
• Opportunities to lead significant projects
• Exposure to strategic content management and development

ASSUMPTION: Growth opportunities in this role align with Rialtic's ongoing expansion and project ambitions.

🌍 Location & Work Environment

Office Type: Remote-friendly with headquarters in Atlanta

Office Location(s): 3490 Piedmont Rd NE, Atlanta, Georgia 30305, US

Geographic Context:

• Primarily remote with necessary EST availability
• Atlanta HQ for any on-site needs or team collaborations
• Flexible remote work benefits to support diverse geographic preferences

Work Schedule: 40 hours per week, flexible within required EST hours

ASSUMPTION: The remote work setup is designed for maximum flexibility, accommodating work from various locations, reflecting a modern work environment ethos.

💼 Interview & Application Insights

Typical Process:

• Initial application review
• Phone or video screening interview
• Technical or skills assessment
• Final interview with department lead

Key Assessment Areas:

• Technical proficiency in medical coding
• Strategic thinking for portfolio management
• Effective communication skills

Application Tips:

• Highlight relevant experience in claims management
• Demonstrate proficiency in FDA regulations and medical coding
• Prepare to discuss previous portfolio management successes

ATS Keywords: Payment Integrity, Medical Coding, FDA Drug Labels, Claims Editing, Team Management

ASSUMPTION: Details on interview processes are inferred based on typical industry standards for professional roles of this nature.

🛠️ Tools & Technologies

• Google Suite for collaborative work
• Medical coding software tools

ASSUMPTION: The role likely involves usage of industry-standard medical coding tools not explicitly named here but are imperative for role efficacy.

👔 Cultural Fit Considerations

Company Values:

• High Integrity
• Customer Value Comes First
• Collaborative Work Culture

Work Style:

• Innovative and solution-focused
• Accountable and results-driven
• Supportive team-based interactions

Self-Assessment Questions:

• How do you handle complex claims editing cases?
• Can you describe a successful coding project you led?
• What strategies do you use for effective client communication?

ASSUMPTION: Cultural fit emphasizes alignment with Rialtic's core values and their application in daily work dynamics.

⚠️ Potential Challenges

• Maintaining up-to-date knowledge of FDA regulations
• Balancing multiple portfolios and projects
• Collaborating across time zones with dispersed teams
• Achieving high-quality content output under tight deadlines

ASSUMPTION: Challenges relate to the inherent complexities in healthcare technology and regulatory requirements.

📈 Similar Roles Comparison

• Greater emphasis on coding precision than general healthcare roles
• Involves strategic management and execution, not typical in basic editing roles
• Requires deeper expertise in regulatory compliance compared to similar positions

ASSUMPTION: Comparison is based on industry trends and typical roles with similar titles.

📝 Sample Projects

• Development of a comprehensive FDA compliance edit suite
• Lead a cross-functional team in a claims improvement project
• Design and implement innovative coding solutions for client needs

ASSUMPTION: Project examples are aligned with typical responsibilities and expected outcomes in this role.

❓ Key Questions to Ask During Interview

• How does the company support professional growth in this role?
• What key achievements has the team recently accomplished?
• How are projects prioritized within the content creation pod?
• What challenges did the previous manager face?
• How are success metrics defined for this position?

ASSUMPTION: Interview questions are designed to offer insights into the role and company expectations, aiding candidate preparation.

📌 Next Steps for Applicants

To apply for this position:

• Submit your application through this link
• Prepare evidence of prior successful project outcomes
• Ensure your resume is keyword-optimized for claims management and coding
• Be ready for a remote interview process
• Maintain clear communication and quick follow-up post-interview

⚠️ This job description contains AI-assisted information. Details should be verified directly with the employer before making decisions.