Associate Director

3 weeks ago

Hyderabad, India R1 RCM Full time

Job Description – Associate Director – Coding Quality


R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work For TM 2023 by Great Place To Work® Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to ‘make healthcare simpler’ and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities.


Job Responsibilities:

  • Lead a team of quality senior managers/managers for multiple business units/customers and across locations
  • Lead closer calibrated quality outcomes for end customers
  • 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 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 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
  • 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


Skills required:

  • 15+ years experience with 5+ years of experience in quality and process excellence leadership with preferred experience in medical coding
  • Lean Six Sigma Black Belt (Preferred)
  • Thorough understanding of transactional quality concepts including sampling methodologies, scoring methods, QMS, Calibration, Gauge R&R etc
  • Hands on experience on using 7 QC tools, lean concepts etc
  • Multispecialty coding experience is preferred including acute and profee coding
  • Good communication, interpersonal skills, people management skills
  • Good understanding of operational and financial metrices



Location: Hyderabad

Shift timings: 12 pm to 9 pm (WFO), Hybrid as applicable as per business requirements

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