devoted · Healthcare · Live in: United States
Posted 2026-10-09 · Verified 2026-10-31
Job Description A bit about this role: The Clinical Readmission Manager is responsible for conducting prepayment and post-payment clinical reviews of inpatient hospital admissions and subsequent admissions to the same or a related hospital within 30 days of the prior discharge date. The auditor reviews claims and medical records for both admissions to determine whether the readmission is clinically related to the prior admission and/or potentially preventable under applicable organizational, regulatory, and Payment Integrity guidelines. This role requires strong inpatient clinical knowledge, sound clinical judgment, and experience reviewing hospital records and readmission cases. The... Read the full ad