Medical Policy Release Manager

Overview

The Medical Policy Release Manager is responsible for managing the medical policies releases, release schedule,andIT systemrelatedupdates. This roleoverseesQA, validation, and release of medical policy content prior to production deployment. This person collaborates with the cross-functional teams creating and maintaining new content, softwarechangeswhich are consistent and correctly reflected across all policy systems.

This role will ensure that new policies or system changes are properly validated, documented, compliant with regulations, and released to production with minimal disruption.

• Release Planning & Scheduling:
  Develop and maintain release calendars for medical policy updates or software patches, coordinate dependencies across multiple teams.

• Compliance:
  Ensure all policy changes or technical releases comply with CMS, federal, state, and regulatory requirements (e.g., Medicare, Medicaid, AMA).

• Coordination & Communication:
  Act as the liaison between Clinical Policy teams, IT, and Business operations to communicate release status, risks, and timelines.

• Quality Assurance &
  
  Risk Management:
  
  Lead go/no-go decisions, validate testing (UAT), and establish rollback procedures to handle potential deployment failures.

• Coordinating tickets, communicating data files status reflected in the Release Notes.

• Having coding and industry expertise in clinical coding edits and its industry references.

• Work with the client teams to provide support on PURs and othereLLinquiries.

• Maintains current knowledge of industry and Cotiviti content, applications, procedures and policies.

• Ability to work well independently and collaboratively with the global team, in a demanding environment.

• Participates ineLLapplications upgrades or functionality changes.

• Manage risks and resolve issues that affect release scope, schedule, and quality.

• Escalates issues requiring executive attention promptly supported by an objective assessment.

• Leverages data for making sound data-driven decision making.

• Complete all responsibilities as outlined in the annual Performance Plan.

• Complete all special projects and other duties as assigned.

• Must be able to perform all duties with or without reasonable accommodation.

• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture thatis able toassist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.

• Complete all responsibilities as outlined in the annualperformance review and/or goal setting.

• Complete all special projects and other duties as assigned.

• Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

• Degree and Professional certification (AHIMA or AAPC) preferred.

• Experience:
  
  6 years of coding experience in healthcare policy, billing & coding software, regulatory analysis, or IT release management.

• Technical
  
  Skills:
  
  Familiarity with ITIL frameworks, Change Management tools (e.g., Jira, Service Now).

• Overseereleasequality, schedule adherence and compliant with Cotiviti standards.

• Plan,schedule and coordinatereleasesofacross development, QA, and production environments.

• Ensure risk assessment, prioritization, approval, and change documentation.

• Manage release calendars, dependencies, and conflicts to minimize business disruption.

• Act as a key liaison across Engineering, QA, Operations andactsas a gatekeeper for policy accuracy.

• Ability to interpret rule descriptions, scripts, and temporary rules.

• Experience validating policy and code changes in content management systems.

• Strong analytical and comparison skills for multi tab validation.

• Work closely witheLLEditors on standardized time frames, thresholds, and definitions.

• Validate changes across Medical Policy, History, and Current Changes to ensure accuracy and consistency.

• Experience in internet-based research as it relates to codes (CPT, HCPCS, ICD, or NDC).

• Familiarity with claims payment and reimbursement methodologies with ability to analyze data.

• Effective at managing timelines and multiple projects with high accuracy and attention to detail.

• Strong analytical, critical thinking, and…