DRG Clinical Validation Director

Director, DRG Validation

Remote (US) | Healthcare Technology | Fully Remote | Direct Hire

Lead the future of healthcare claims validation and make a measurable impact on recovery outcomes as a DRG Clinical Validation Director. If you’re passionate about mastering the complexities of MS-DRG and APR-DRG validation while driving operational excellence, this fully remote role offers a unique leadership opportunity to shape a high-performing team in a dynamic, growth-focused environment.

You'll thrive here if:

• You take ownership of scaling and leading a robust DRG Clinical Validation program to meet ambitious revenue and growth targets.
• Managing and mentoring a team while balancing productivity, quality, and retention is where you excel.
• You enjoy overseeing clinical claims workflows and driving continuous improvement through insightful data analysis.
• Collaborating across product, data, tech, and operations teams to create innovative clinical validation solutions excites you.
• You’re comfortable navigating client-facing discussions, complex claims, and ensuring rigorous validation policies and training.

You'll Need to Bring:

• Experience in DRG clinical validation with strong expertise in MS-DRG and APR-DRG methodologies.
• Proven leadership managing production-driven audit teams, ensuring accountability and performance.
• Data-driven mindset with a history of managing operational metrics like SLAs, quality, and capacity.
• Ability to analyze trends, diagnose performance issues, and implement effective solutions.
• Healthcare technology or high-growth startup experience is a plus.

What’s in It for You:

• Salary: $130,000–$160,000
• Benefits: Health, Dental, Vision, 401(k)

If you thrive in a fast-paced, high-change environment where your expertise influences critical healthcare outcomes, this is the role for you. Join a forward-thinking team eager to innovate healthcare validation. Apply now to start making a difference!