Content Policy Manager

Client Payment Integrity Policy Manager

Overview

As a Client Payment Integrity Policy Manager, you will serve as a trusted partner to our clients, helping them optimize and manage their claims editing portfolios to maximize identification of potential overpayments. This role sits at the intersection of client engagement, healthcare payment policy expertise, and strategic content management. You will not only respond to client needs but also guide them toward approaches that generate maximum long-term value, balancing immediate requests with what drives the greatest impact for their long-term business outcomes.

You will work closely with client management, product, engineering, and strategic content leadership—deeply embedded in both our client and internal teams. This is an opportunity to combine subject matter expertise with consultative influence, helping clients transform how they manage payment integrity policies while advancing the overall roadmap of our platform.

Responsibilities

Client Partnership & Policy Expertise

• Act as the primary subject matter expert and trusted advisor to clients on payment integrity policies and claims editing.
• Creatively tailor and fine-tune policies to client-specific circumstances, ensuring maximum savings while minimizing provider abrasion.]
• Guide clients to balance short-term requests with long-term strategies that generate sustainable impact.
• Present and explain policy rationale, value, and implications during client interactions.

Strategic Value & Insights

• Prioritize and recommend policies based on savings potential, client needs, and strategic alignment.
• Quantify and clearly communicate the value of policies using data-driven analysis.
• Identify adoption gaps, inefficiencies, or emerging opportunities and work with clients to address them.

Cross-Functional Collaboration

• Partner with Client Success to integrate into client workflows and decision-making.
• Communicate client policy needs in a way that informs and shapes product requirements, influencing the roadmap where appropriate.
• Collaborate with product, engineering, and content leadership to ensure client perspectives are reflected in platform evolution.

Execution & Delivery

• Oversee policy implementation processes, ensuring accuracy, timeliness, and measurable results.
• Develop clear, client-facing content materials, analyses, and reporting.
• Track and report on client adoption trends, decisions, and outcomes.

Qualifications

Required

• 5-7 years of work experience in payment integrity at a health plan, claims editing vendor, or similar environment.
• Coding, billing, or auditing credentials (e.g., CPC, CCS, or equivalent specialty certifications). A certification in coding is mandatory for this position.
• Expertise in interpreting medical policies, applying correct coding guidelines, and understanding the top claims error reasons.
• Demonstrated experience advising clients and explaining complex medical policy/payment accuracy concepts.
• Strong analytical skills with the ability to quantify and communicate policy value.
• Proven experience managing claims editing implementations or similar client delivery initiatives.

Preferred

• Expertise across both professional and institutional claims.
• Advanced skills with Google Suite or similar tools.
• Experience working cross-functionally with product and engineering teams.
• Excellent written and verbal communication skills with strong influencing ability.
  
  

TO ALL RECRUITMENT AGENCIES:
Rialtic does not accept agency resumes. Please do not forward resumes to Rialtic employees or any other company location. Rialtic is not responsible for any fees related to unsolicited resumes and will not pay fees to any third-party agency or company that does not have a signed agreement with the Company for this specific role.