DRG (Diagnosis-Related Group) Business Solutions Lead
Posted
Tech Stack
Responsibilities
- Define product requirements, audit methodologies, and business logic to support accurate, scalable audit workflows.
- Translate Official Coding Guidelines and MS/APR-DRG Definitions into structured, codifiable audit logic.
- Define and maintain the DRG audit prompt library.
- Partner with product management on product vision, roadmap prioritization, and payment integrity solutions.
- Partner with data science and AI teams to define clinical entity extraction targets and test/refine NLP model outputs.
Benefits
- Equity
- Health Insurance
- Remote Stipend
- Remote Work
Culture
Mission-DrivenCollaborative SpaceInclusive HiringCareer Ladder
Requirements
Required: RN with 7+ years of progressive DRG audit experience
Regions: Us
Get jobs like this in your inbox
Weekly AWS, Azure, Express hiring trends and salary data — free.
Join 8 engineers getting weekly insights
Get job market intelligence in your inbox
Free weekly insights on tech hiring trends, salaries, and in-demand stacks.
Already a subscriber? Sign in
About abacusinsights
Industry: healthtech
Size: medium
Abacus Insights is transforming how data works for health plans by building a single, trusted data foundation to support better decision-making.
View company profile →Compensation
Equity: Eligibility for equity grants
Bonus: Eligibility for performance bonuses
Similar Jobs
Payment Integrity Business Solutions Lead (Complex Claims)
abacusinsights · United States
Senior Clinical Informaticist
Cohere Health · United States
$75k
Principal Data Engineer
Eclinical Solutions · Mansfield, MA 2-3x a week
$115k
Sr. Data Scientist
Patientpoint · Cincinnati, Ohio, United States; Remote, US
Remote
$143k – $211k
Clinical Informaticist II
dandelionhealth · Remote
Remote