Senior Director
Position Title: Sr. Director (Quality & Training, Medical Coding)
Function: Coding
Location: Hyderabad
Reporting To: Vice President
Job Responsibilities:
- Lead a team of Training and Quality Associate Directors and Operations Delivery leaders for multiple business units/customers and across locations
- Lead calibrated quality outcomes for end customers
- Lead training initiatives for the existing and new clients- finalise training plans for various sources of hired resources
- Innovate and restructure training curriculums to suite business needs and also manage cost
- Drive customer satisfaction for quality of coding output including corrective and preventive actions for customer quality concerns
- Build and operate a predictable quality model and well aligned outcome-based quality assurance unit for coding
- Actively collaborate new customer engagements for better training and quality outcomes including calibration, SOP inputs
- Drive the structure and governance for ongoing customer calibrations
- Collaborate and drive coding compliance reviews, alignment, and actions
- Lead quality representation in business reviews weekly, monthly, and quarterly as well customer and internal stakeholders/leadership visits
- Drive high level of visibility on business performance and measures to relevant internal stakeholders.
- Actively lead collaborative efforts and cohesive outcomes between US and Global QA teams
- Drive and guide analytics for comprehensive quality dashboards along with business insights and publish for internal stakeholders and leaders.
- Drive quality transformation initiatives and continual process improvement
- Create effective quality sampling process and governance
- Drive QA effectiveness and alignment with customer perceived quality
- Collaborate with product team to build and manage comprehensive QA workflow tool along with reporting and insights capabilities
- Drive process improvement initiatives including process reengineering, lean and automation initiatives to drive efficiency
- Drive value-based initiatives including upstream opportunities from AR to coding, coding denials to abstract coding as well coding optimization, benchmarking, and CDI/provider education initiatives as well technology initiatives such as autonomous coding, coding edits/scrubbers and auto fixes
- Collaborate with training team to drive effective feedback loop to address quality and training gaps through onboarding training
- Drive high performing quality operations with closer governance on KPIs such as productivity, absenteeism, shift adherence, utilization, productive time etc
- Drive high people engagement including framework for periodical connects including 1 to 1, skips, FGDs as well use the people survey tool to drive meaningful actions, EWS and employee retention and govern attrition
- Manage all exceptions and escalations for quality team
- Drive people development efforts and framework around IDP and R&R initiatives and be an inspiring people leader
- Closely work with operations to meet dynamic business needs on quality support
- Review and govern external audits rebuttals and final outcomes
- Govern transactional quality operations as well drive strategic initiatives and implement best QA practices
- Identify process improvement/business excellence/process reengineering opportunities and drive further
- Drive automation and transformation initiatives.
Required Experience:
- Minimum 18 Years of Experience in managing Multispecialty Coding (inpatient and outpatient) in RCM/US healthcare along with understanding on Quality and Training Concepts - Provider experience preferred.
- Exposure to digital solutions, automation, AI and analytics and ability to implement digital solutions
- Analytical and structured approach with extensive experience in implementing high impact projects and delivering transformation projects in scale.
- CPC certification is required.
Qualification:
- Graduate in any stream.
