Senior Director

About R1 RCM

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration. 

With over 30,000 employees globally and a robust presence in India, comprising over 17,000 employees across Delhi NCR, Hyderabad, Bangalore, and Chennai, we foster an inclusive culture where every team member feels valued and empowered. Our mission is to transform the healthcare industry by driving efficiency for healthcare systems, hospitals, and physician practices, continuously striving to make healthcare work better for everyone. 

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.

Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm.com

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