Director Transactional Quality, US Healthcare RCM

Role:

Principal Duties and Responsibilities

1. To conduct performance management of quality analysts and play a role in satisfying their developmental needs

2. Responsible to ensure quality coverage across different work scope of a project

3. Allocate work in proportion to the productivity goals and guidelines

4. Monitor the performance levels of quality analyst and improve upon the areas of opportunities

5. Ensure that quality analysts are minimum at 98% calibration with client quality levels

6. Create dashboard, perform analysis, work out sampling methodology etc all other performance indicative MIS

7. To comprehend & translate customer needs into viable processes

8. Keep the customer complaints & concerns in check and execute the action plan as agreed

9. Meet and exceed all expectations of organizations quality management system (QMS)

10. Drive / support Business Excellence initiatives; high impact projects which are cross functional and cross geography.

11. Assist with tracking of all initiatives, coordinating internal and external audits for ISO certifications, internal process

12. Implement strong governance to address Operations Quality and Improvement projects and initiatives.

13. Support/ drive strategic Lean / Six Sigma and other Continual Improvement projects and initiatives by providing basic data analytics, dashboards, coordinating projects

14. Support independent reporting practices such as troubled account status, contractual metrics tracking and reporting.

15. Generate business impact through Continual Improvement initiatives.

• Experience:

  13+ years in US Healthcare Revenue Cycle Management (RCM), with at least 3 years in a Quality function.

• Current Role:

  Senior Manager or above, managing Quality teams in Medical Billing and Accounts Receivable.

• Skills:

• Strong team management and leadership capabilities.
• Proficient in change management and facilitation.
• Excellent program and project management skills.
• Deep understanding of quality concepts and tools.
• Expertise in end-to-end process mapping and process improvement/re-engineering.

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