Jobs in the United States

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Added 2 mins ago
Project Manager
GPAC
Dallas, TX
An established Dallas-based development and project management firm is seeking an experienced Project Manager to join its team to work on major, high-profile projects.
Added 4 mins ago
Project Controls Manager
SLB
Houston
SLB is seeking a motivated Project Controls Manager to support our Data Center infrastructure solutions business.
Added 9 mins ago
Telecommunications Specialist 4 (Technical Specialist 4) - San Antonio, TX
M.C. Dean, Inc
San Antonio, TX
Provide ISP/OSP input to the project's lead engineer and program manager for design reviews, plan acceptance, and program team meetings.
Added 9 mins ago
Superintendent 1 - Security Systems - Dallas, TX (Travel Required)
M.C. Dean, Inc
Dallas, TX
At least two (2) years' experience managing security projects as a Project Manager, Superintendent, or Project Foreman
Added 9 mins ago
Information Security Specialist (US)
TD Bank, N.A.
Mount Laurel, NJ · Fort Lauderdale, FL
Acts as a lead expert resource in technology controls / information security for project teams, the business / organization and/or outside vendors
Added 16 mins ago
Senior Manager, MSAT
PCI San Diego, Inc.
San Diego, CA
The Senior Manager, Technical Documentation provides strategic, technical, and operational leadership for the Manufacturing Science & Technology (MSAT) documentation function, ensuring the…
Added 16 mins ago
BE
Manager Fraud Operations
Boeing Employees' Credit Union
Remote, United States
- $89,000 to $164,700 USD / year
As the Manager, Fraud Operations, you will play a critical role in protecting our members, employees, and organization from fraud-related threats. You will lead a team responsible for fraud…
Added 16 mins ago
WP
Controls Engineer (Part-Time)
West Pharmaceutical Services
Jersey Shore, PA
- Part-time
…planning, scheduling, execution of projects and communicating project status to targeted timelines. This individual will also manage/assist in facility…
Added 17 mins ago
Director of Building Envelope and Design
IPS Integrated Project Services
Blue Bell, PA
…innovative solutions for the consulting, architecture, engineering, project controls, procurement, construction management, and CQV of technically complex facilities, primarily in the life…
Added 17 mins ago
Manager, Distribution Network Strategy
J&J Family of Companies
Horsham, PA
…functions to apply appropriate GxP, compliance, and security controls; support the Vendor Manager with health authority inspections and GxP audits; and enable supplier audit…
Added 17 mins ago
Controller
Concurrent Technologies Corporation
Johnstown, PA
…functions, financial reporting, regulatory compliance, and internal controls. This position ensures the accuracy, integrity, and timeliness of financial information while driving process…
Added 18 mins ago
OSP Facilities Long Haul Deployment Construction Project Manager - ILA Construction
Zayo
Harrisburg, PA
The OSP Facilities Long Haul Deployment Construction Project Manager - ILA Construction utilizes tight project controls and proactive problem solving to anticipate and mitigate issues and…
Added 18 mins ago
Project Manager 4 (Project Manager/SRE)
GovCIO
Harrisburg, PA
GovCIO is currently hiring a Project Manager to support the VA experience to support the Department of Veterans Affairs (VA) Project Management team to oversee the day to day operations,…
Added 18 mins ago
C
Program Manager, EBMS
CBRE
Harrisburg, PA
- $105,000 to $115,000 USD / year
Proficiency with project/program managementtracking software (e.g. SmartSheets, Asana, QuickSight (Power BI), MS Project,etc)
Added 18 mins ago
Employer Account Executive - Remote
Prime Therapeutics
Harrisburg, PA
The Account Executive serves as the primary relationship manager for multiple accounts in an assigned market segment. The role works directly with groups to optimize pharmacy spend through…
Added 18 mins ago
Vice President, Cloud Platform Engineer
SitusAMC
Harrisburg, PA
Collaboration & Communication: Partner with internal and external stakeholders on design and architecture decisions and provide clear project updates to leadership.
Added 18 mins ago
Engineering Project Manager - Turbine Mechanical Solutions
Emerson
Pittsburgh, PA
At Emerson, it’s about more than technology, it’s about purpose. If you are a project management professional who wants to lead work that truly matters, this role offers a unique…
Added 18 mins ago
Accounts Payable Manager
WESCO
Pittsburgh, PA
As a Manager - Accounts Payable, you will manage all activities within the accounts payable function. You will ensure timely and accurate processing of vendor invoices and payments while…
Added 18 mins ago
Lead Certified Coder QAOI- Remote
UPMC
Pittsburgh, PA
Clinical, claim financial ties, HCC diagnosis coding, quality data science, IT process controls, IT SDLC or advanced project management.
Added 23 mins ago
Travel Civil Project Manager- Mission Critical
STO Building Group
Tulsa, OK
The Civil Project Manager is responsible for the overall planning, management, and execution of work for assigned construction projects. May be assigned responsibility for one or more…
Added 23 mins ago
Travel CX Manager-Mission Critical
STO Building Group
Eagle Mountain, UT
As a Project Manager, CX (Commissioning Manager) you will take charge of planning, coordinating, executing, and overseeing all commissioning activities. You will bring deep expertise in the…
Added 23 mins ago
Travel CX Manager-Mission Critical
STO Building Group
Tulsa, OK
As a Project Manager, CX (Commissioning Manager) you will take charge of planning, coordinating, executing, and overseeing all commissioning activities. You will bring deep expertise in the…
Added 23 mins ago
Travel CX Manager-Mission Critical
STO Building Group
Kansas City, MO
As a Project Manager, CX (Commissioning Manager) you will take charge of planning, coordinating, executing, and overseeing all commissioning activities. You will bring deep expertise in the…
Added 23 mins ago
Travel CX Manager-Mission Critical
STO Building Group
Hutto, TX
As a Project Manager, CX (Commissioning Manager) you will take charge of planning, coordinating, executing, and overseeing all commissioning activities. You will bring deep expertise in the…
Added 25 mins ago
Sr Analyst, Contract Implementation & Audit
Baxter Healthcare Corporation
Deerfield, IL
…contract set-up accuracy, adherence to pricing and compliance controls, and readiness for internal and external audit review. Drives continuous improvement through standard work,…

UPMC

Lead Certified Coder QAOI- Remote

Pittsburgh, PA, United States

Remote

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Job details

Workplace: Remote
Posting language: English
Posted: Oct 24, 2026

Original job description

UPMC Health Plan has an exciting opportunity for a Lead Certified Coder Quality Assurance Operational Integrity position. This is a full-time position working Monday through Friday daylight hours. This is a remote position.

The Lead Certified Coder QAOI will provide front line leadership to the professionals who conduct quality assurance and operational integrity assessments and reviews across the Insurance Services Divisions' portfolio of products, services, and functional departments, supporting ISD stakeholders and leadership to mitigate risks, ensure operational integrity, and compliance in the achievement of initiatives, business goals, and objectives. The QAOI Lead provides technical, employee and operations support to a diverse team of highly skilled quality assurance and operational integrity risk management professionals with functional expertise in clinical, financial, operational, healthcare, insurance products, IT protocols, business intelligence, and more. This position plays a crucial role in the prioritization and coordination of various team assignments and projects to help drive team results and operational efficiency.

To be considered for this position candidates must be a certified coder and have a CPC Certification.

Responsibilities:

Serves as a positive extension of the leadership team, protects the departments' brand and reputation, as well as contributes to building a positive QAOI work community.
Educates QAOI and ISD leadership on best-in-class risk management protocol.
Mentors and Coaches Senior QAOI professional staff.
Successfully lead and/or participate on workgroups/projects/initiatives to drive results.
Thorough understanding of the Stakeholder performance expectations, department vision, mission, objectives and aligns responsibilities accordingly.
Demonstrate value added by capturing cost-benefit analysis.
Responsible for the distribution of work assignments for the team, as well as workload management.
Oversee the day-to-day activities and provides guidance/assistance, as necessary including coordination of new staff orientation.
Serve as a process and technical expert, providing training and support as needed.
Assume manager support and quality control as needed.
Help professionals resolve complex challenges/issues related to their work.
Maintain department policies, procedures, guidelines and ensures the integrity QAOI internal operations.
Evaluate and document stakeholder needs, including current processes and proposed revisions.
Assist with most complex QAOI projects/initiatives/reviews executing superior auditing processes, best in class risk management, or project management skills.
Excels at generating succinct report findings and workpapers.
Conducts quality reviews of professional staff outcomes.
Will cover workloads as appropriate.

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Bachelors degree or equivalent professional experience, along with 7 years of related experience in quality assurance, operational controls, risk management, auditing, or customer service.
CIA certification preferred.
1 year experience leading or facilitating meetings.
1 year experience coaching and mentoring. Strong knowledge of a healthcare portfolio of products, services, and/or functional departments or experience auditing in a heavily regulated industry required.
Healthcare specialization in any of the following disciplines strongly preferred:
Clinical, claim financial ties, HCC diagnosis coding, quality data science, IT process controls, IT SDLC or advanced project management.
Ability to comprehend and apply relevant information to tasks and assignments.
Detailed oriented with advanced critical thinking skills, advanced analytical skills, and advanced project management skills.
Excellent oral, written, and reporting communication skills.
Must possess a professional demeanor with the ability to manage multiple priorities and meet deadlines required.
Proficiency using MS Teams, Word, and Excel.
Ability to learn Visio and auditing technology.
Ability to apply data extraction and leverage data extraction tools.Licensure, Certifications, and Clearances:CIA, Six Sigma, PM, or SAFe preferred. UPMC is an Equal Opportunity Employer/Disability/Veteran

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More about this job

Skills

Quality assurance
Leadership
Regulatory compliance
Risk management
Provide training
Quality control
Auditing
Project management
HTML
Customer service
Coaching
Critical thinking
Analytical skills
Reporting
Communication skills
Meet deadlines
Microsoft Teams
Microsoft Word
Microsoft Excel
Microsoft Visio

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