Operation Delivery Lead

Job Description

R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. 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, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better

R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place sto Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 16,000+ strong in India with presence 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.

Position Title: Operation Delivery Leader (Coding Quality)

Function: Coding

Location: Hyderabad

Shift Timings: 12:00 to 22:00 Hrs. (flexible)

Reporting To: Director

Responsibilities:

Lead a team of quality senior managers/managers/ assistant 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 initiativesand 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.

No of years of Experience: Minimum 18 Years of Experience in managing Multispecialty Coding in RCM/US healthcare is preferred along with understanding on Quality Concepts.

Minimum Qualification: Graduation.

Required Qualifications

- License/Certifications: Currently holds and maintains at least 1 role-related certification (CCS or CIC for inpatient roles, CPC, COC, CCS, CCS-P for outpatient roles, CPMA for auditing role).
- Additional certifications in specific specialties (CEMC, CASCC, CEDC, CGSC, CHONC, CIRCC, COBGC) are a plus.
- Experience in professional and facility coding.
- Strong knowledge of CMS guidelines, Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) edits, and Inpatient Prospective Payment System (IPPS).

Desired Qualifications

- Experience in RCM/US Healthcare: Preference strong domain understanding of US healthcare (Payer/Provider) Provider experience preferred. To learn more, visit:
- Excellent communication skills, presentation skills, and proficiency in MS Excel & PowerPoint.

- Education - Bachelor's degree in a medical allied course is preferred. For other courses, a high level of knowledge and relevant work experience to illustrate capability.
- Proficiency in medical terminologies and disease processes.
- Strong attention to detail.
- Ability to work independently and as part of a team.
- At least 1 year of experience as a quality auditor is preferred.
- Experience working with coding software such as Epic, Cerner, Meditech, and 3M 360.

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:

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