Director of Quality

1 day ago

Belgaum, India Etenico Technologies Full time

Job Title: Director – Delivery Quality (US Healthcare)Position Summary Location:- Chennai /Hyderabad/BangaloreThe Director – Delivery Quality will lead and strengthen Omega Healthcare’s delivery quality framework across US healthcare revenue cycle management (RCM), medical coding, and CDI. The role involves ensuring compliance with client SLAs and regulatory standards (HIPAA, CMS, ICD-10, CPT, HCPCS), driving continuous improvement initiatives, supporting technology-driven enhancements, and fostering a culture of operational excellence across delivery center.Key ResponsibilitiesDevelop and manage delivery quality standards across RCM processes (coding, CDI, AR, billing).Ensure compliance with client SLAs and US healthcare regulatory guidelines.Lead internal and external audits, define corrective/preventive actions (CAPA), and resolve escalations promptly.Drive process improvements using Six Sigma/Lean methodologies; partner with CQ and delivery teams to build a strong quality culture.Collaborate with delivery heads and client teams for governance, RCA reviews, and quality reporting.Track and report key quality metrics (accuracy %, DPU, DPO, SLA adherence, audit scores).Mentor and develop quality teams; design and implement training programs aligned with regulatory updates and client requirements.Design and execute optimization projects to enhance quality team efficiency and resource utilization.Support identification, coordination, and execution of all technology-led initiatives within the quality span.Qualifications & ExperienceBachelor’s degree in Life Sciences/Healthcare Administration (Master’s preferred).20+ years of experience in Delivery Quality/RCM, with 7+ years in leadership roles.Mandatory experience in Physician or Hospital RCM (end-to-end quality management, coding quality, CDI, audits, provider documentation, or operational quality oversight).Strong knowledge of medical coding quality, CDI, clinical documentation, and RCM operations.Expertise in the complete RCM cycle of Hospital Billing.Certifications in Six Sigma/Lean/Quality preferred (Green Belt/Black Belt).Proven experience managing client governance, escalations, process improvements, and deploying advanced tech-enabled quality solutions.Skills & CompetenciesLeadership & People DevelopmentUS Healthcare Quality & Compliance ExpertiseAnalytical & Problem-Solving SkillsClient & Stakeholder ManagementProject Management & Continuous ImprovementStrong Communication & Conflict Management

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