DRG Quality Manager

EXL
On-site
Posted 2 days ago
Healthcare-Quality-Manager

AI summary

The DRG Quality Manager manages a team of quality analysts who review and validate MS-DRG and APR-DRG audit accuracy, ensuring proper coding and reimbursement outcomes. The role requires strong leadership and knowledge of coding guidelines and CMS regulations.

Eligible from: US only

Job Description

The role directly manages a team of DRG quality analysts responsible for reviewing auditor-completed MS-DRG and APR-DRG work, validating audit accuracy, and ensuring accurate coding and reimbursement outcomes. This leader may also oversee additional quality specialties within clinical or coding audit programs. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in Coding Guidelines, Coding Clinic, audit tools, and a solid understanding of CMS regulations, payer requirements, and quality governance.

Salary Range: $100,000 – $120,000, based on experience, skills, and qualifications.

Location: 100% Remote, U.S.-based.

Travel: Limited travel may be required for team meetings.

A brief coding/auditing assessment may be included as part of the interview process.

For more information on benefits and what we offer, please visit us at

Originally posted on Himalayas

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About the job

Posted on
Oct 5, 2026
Job type
Full-time
Location
United StatesOn-site

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