Content Policy Manager
Posted Updated
Description
Content Policy Manager, Research and Scoping
Payment Integrity | Rialtic, Inc.
ABOUT RIALTIC
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors including Oak HC/FT, F-Prime Capital, Health Velocity Capital, and Noro-Moseley Partners, Rialtic's best-in-class payment accuracy platform brings programs in-house and helps healthcare organizations gain full control over processes traditionally managed by fragmented vendors. Today, we partner with leading healthcare insurers and providers to tackle a $1 trillion problem — reducing costs, increasing efficiency, and improving quality of care. Learn more at
THE ROLE
As a Payment Accuracy Policy Manager, you will serve as a critical bridge between healthcare payment expertise, client strategy, and product innovation. This role combines deep subject matter knowledge with strategic influence — driving the development of payment integrity policies that protect our clients while advancing Rialtic's platform capabilities.
You'll lead the research, evaluation, and implementation of new policies based on CMS guidelines, Medicaid requirements, industry standards, and emerging medical cost trends. Working closely with client management, product, engineering, and content leadership teams, you'll translate complex payment policy concepts into actionable strategies that deliver measurable value. This is an opportunity to shape how health plans approach payment integrity while building the content foundation that powers our enterprise platform.
WHAT YOU'LL DO
• Source, interpret, and scope new payment integrity policies to expand Rialtic's claims editing content library. • Prioritize policy updates based on savings potential, client impact, and strategic alignment with platform goals.
• Leverage CMS, Medicaid, clinical guidelines, and industry trends to identify opportunities for new content development.
• Quantify and communicate policy value through data-driven analysis and clear financial impact assessments. • Identify adoption gaps, implementation inefficiencies, and emerging opportunities within client programs. • Work closely with product and engineering teams to ensure client needs inform platform development. • Collaborate with content leadership to maintain consistency, quality, and relevance across the policy library.
• Serve as the payment integrity expert across enterprise initiatives, providing consultative guidance to internal teams.
WHAT YOU BRING
• 5–7 years of experience in payment integrity at a health plan, claims editing vendor, or similar healthcare organization.
• Active coding certification (CPC, CCS, or equivalent specialty certification) — required for this position.
• Proven expertise interpreting medical and payment policies, applying CMS and Medicaid reimbursement guidelines, professional and outpatient coding standards, and identifying and resolving common claims payment errors.
• Demonstrated ability to advise clients and explain complex payment accuracy concepts in clear, accessible terms.
• Strong analytical skills with experience quantifying policy impact and ROI.
• Track record of managing claims editing implementations or similar client-facing initiatives.
NICE TO HAVES
• Expertise across both professional and institutional claims environments.
• Advanced proficiency with Google Suite or similar collaboration tools.
• Experience working cross-functionally with product and engineering teams in a SaaS or health tech environment.
• Exceptional written and verbal communication skills with the ability to influence stakeholders at all levels.
WHY YOU'LL LOVE IT HERE
At Rialtic, you'll be part of a team that's bold, mission-driven, and values-centered:
• High Integrity: Do the right thing. Be candid, humble, and respectful.
• Customer Value Comes First: Our customers are our North Star.
• Work as One Team: Collaboration and inclusion drive better outcomes.
• Be Bold & Accountable: Speak up, take ownership, and keep improving.
• Pursuit of Excellence: Innovate, iterate, and raise the bar.
• Take Care of Yourself & Others: Wellbeing matters — for everyone.
We offer remote-first flexibility with a home office stipend, meaningful equity and 401(k) match, an open and flexible PTO plan, comprehensive medical/dental/vision plans, and wellness reimbursements including access to TalkSpace, Teladoc, and One Medical.
DON'T MEET EVERY QUALIFICATION?
DON'T MEET EVERY QUALIFICATION?
Studies show that women and people of color are less likely to apply to jobs unless they meet every qualification listed. At Rialtic, we're building a diverse, inclusive, and authentic workplace — if you're excited about this role but your experience doesn't align perfectly with every qualification, we encourage you to apply anyway. You may be just the right candidate for this or another role.