Duties and Responsibilities:

1. Learning & Development / Training Management:

- Design and execute effective L&D strategies.

- Lead, coach, and manage the trainer team.

- Assess training needs, develop modules, deliver programs, and measure impact to continuously improve effectiveness.

- Personally deliver coding training when required.

- Establish competency frameworks and certification mechanisms for coding teams.

2. Process Excellence & Continuous Improvement:

- Lead process excellence initiatives and CI projects to improve operational efficiency and quality.

- Identify improvement opportunities using data, audits, and operational metrics.

- Drive root cause analysis and implement sustainable corrective actions.

- Partner with operations teams to standardize processes and implement best practices across teams.

3. Risk Management & Compliance:

- Identify and analyze risks affecting coding operations and collaborate with stakeholders on mitigation planning and implementation.

- Manage Operational Assurance (OA) audits, compliance reviews, and quality governance.

- Ensure adherence to regulatory standards, internal SOPs, and coding compliance frameworks.

4. Program & Project Management:

- Lead organizational initiatives across departments, ensuring alignment with business objectives.

- Plan, coordinate, and monitor operational projects to ensure deliverables meet defined scope, timelines, and quality standards.

- Track project progress through governance forums, dashboards, and structured reporting.

Education:

- Bachelor's degree in Life Sciences, Pharmacy, Nursing, or related healthcare discipline.

- Professional coding certifications such as CPC / CCS / COC preferred.

- Lean Six Sigma or Process Excellence certifications will be an added advantage.

Experience:

- 8+ years of overall experience in Healthcare RCM / Medical Coding operations.

- Minimum 1 years of hands-on coding experience in E&M and Emergency Department (professional and facility).

- Minimum 2 years of leadership experience managing teams in an Assistant Manager role or above.

- Experience managing operational governance, training frameworks, and improvement initiatives.

- Proven experience working with internal and external stakeholders.

Role Expectations:

1. Demonstrate Structured Analytical Thinking:

- Approach scenario-based questions using a structured framework (Situation - Analysis - Action - Outcome).

- Explain how the problem is diagnosed, not just the action taken.

- Clearly describe root cause analysis methods such as 5 Whys, Fishbone analysis, and trend analysis.

2. Emphasize Governance and Process Frameworks:

- Be prepared to explain coding quality governance models such as audit frameworks, QA checkpoints, error tracking, and compliance monitoring.

- Describe how governance is maintained through SOPs, dashboards, escalation matrices, and periodic reviews.

- Explain how to ensure process standardization across large teams.

3. Highlight Operational Metrics and Data-Driven Decision Making:

- Clearly articulate key operational health metrics, such as: Productivity, Quality / Error Rate, Turnaround Time (TAT), Utilization, and SLA Adherence.

- Demonstrate how these metrics are tracked, analyzed, and used for improvement through dashboards and reporting.

4. Showcase Risk Monitoring and Control Mechanisms:

- Explain proactive risk monitoring practices including early warning indicators, audit findings, and exception tracking.

- Describe how risks are identified, assessed, mitigated, and reported through governance forums.

5. Provide Clear Examples of Continuous Improvement Initiatives:

- Share specific projects where operational improvements were implemented, including: Problem identified, Initiative implemented, Metrics improved, and Quantifiable results (e.g., quality improved by X%, TAT reduced by Y%).

6. Explain Training Effectiveness Measurement:

- Be prepared to explain how training impact is measured through: Pre- and post-training assessments, Quality score improvements, Productivity improvements, Reduction in error trends, and Certification or competency frameworks.

7. Demonstrate Strategic Leadership for Large Teams:

- Provide examples of managing large teams with structured governance, including: Weekly / monthly operational reviews, Performance dashboards, Leadership reporting, and Action tracking and accountability.

8. Move Beyond Transactional Management:

- Focus on demonstrating strategic thinking, not just daily task management.

- Show how decisions are driven by: Data insights, Long-term operational planning, and Performance trends and governance reviews.