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15/06 Abirami
Talent Acquisition Specialist at Riamin Infotech

Views:1394 Applications:10 Rec. Actions:Recruiter Actions:0

Director - Medical Coding - MBBS (9-20 yrs)

Noida Job Code: 583701

Primary Responsibilities:

- Provide leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff

- Develop and execute strategies for a function or discipline that span a large business unit or multiple markets/sites

- Direct others to resolve business problems that affect multiple functions or disciplines

Required Qualifications:

- Medical Science Graduate from recognized University - MBBS

- 12-15 years of experience in managing large scale operations in Clinical or Medical Coding field

- Extensive experience in interactions with Clients/Onshore teams

- Hands-on experience in managing P/L for the Process

- Handled minimum span of 200-400 FTE- s

- Open to Travel

- Flexible to work shifts: 2PM-11PM (US timings)

Preferred Qualifications:

- Certifications in Medical Coding from AAPC or AHIMA (CPC, CIC, COC, CCS, etc.)

Values Based Competencies:

- Model and Ensure Ethical Behavior

- Deliver Value to Customers

- Lead and Develop People

- Lead Change and Innovation

- Communicate Effectively

- Drive Sound, Disciplined Decisions

- Drive High-Quality Execution and Operation Excellence

Functional Competencies:

- Review and Implement Medical and Clinical Protocols for Staff Oversight and Development:

- Leverage clinical acumen to provide guidance to staff (e.g., disease state, health conditions)

- Assist staff in navigating the medical management system (e.g., find resources, answers questions)

- Provide oversight and review of coordination of care (e.g., chronic condition management, utilization management, case management)

- Ensure employees are current with clinical licensure and certifications

- Develop/oversee/deliver operational or technical training

- Plan/Implement/Manage Medical and Clinical Ops Programs

- Develop policies, procedures, and guidelines for medical and clinical operations programs

- Review/approve policy and process changes

- Evaluate regulatory changes and determine steps needed to implement in programs

- Develop medical and clinical operations program goals

- Identify and implement business development opportunities to support growth of medical and clinical operations programs

- Oversee/navigate technology and software applications utilized in the delivery of medical and clinical operations programs

- Oversee management/service delivery systems utilized in member care

- Intervene in resolution of member or employee complaints or issues as necessary-Create and implement a business continuity plan to minimize interruptions to the business

- Ensure Compliance of Medical and Clinical Ops Programs and Services

- Interpret compliance/clinical/medical reports

- Evaluate compliance with Federal, State, and Local regulatory and organizational guidelines

- Evaluate programs and services against accreditation standards

- Evaluate programs and services against contractual requirements

- Oversee ongoing monitoring and internal auditing against relevant guidelines and standards

- Implement process improvement activities to address areas of non-compliance or ensure procedures are followed

- Measure employee/provider performance against internal procedures and protocols

- Ensure team members address gaps in performance against internal procedures and protocols

- Monitor/Evaluate Overall Medical and Clinical Ops Service, Employee Performance

- Develop and communicate performance metrics and expectations

- Direct data collection and measurement of outcomes (e.g., customer surveys)

- Apply metrics to evaluate services, employee performance, and program outcomes

- Read and interpret reports (e.g., performance, service)

- Identify causes of performance deficiencies and determine appropriate follow up actions

- Drive implementation of best practices and standards

- Plan and Manage Medical and Clinical Operations to Ensure Financial Viability

- Develop operational budgets for medical and clinical operations

- Evaluate staffing ratios, stratification of care, overtime, agency usage, or level of position to effectively manage labor expenses

- Read financial reports, identify reasons for financial performance gaps, and identify opportunities for improved financial performance and enhanced return on investment

- Collect and review data to evaluate financial outcomes of programs and services

- Conduct cost/benefit analysis on programs to drive efficiencies

- Conduct competitive analysis and identify opportunities to enhance financial viability

- Propose and obtain approval for capital expenditures for medical and clinical operations

This job opening was posted long time back. It may not be active. Nor was it removed by the recruiter. Please use your discretion.

Women-friendly workplace:

Maternity and Paternity Benefits

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