Market Services PB Coding Director
3 weeks ago
DescriptionJob Summary:The Director, Market Services Coding is a member of the Kaiser Permanente Program Offices Middle Revenue Cycle team and reports to the companys Senior Director, Enterprise Professional Services Coding Operations. This position will provide Middle Revenue Cycle leadership/program office support and services to regions/markets in Professional diagnosis and procedural coding, data quality/integrity, coding compliance, coding and Hospital CDI QA & enterprise coding education and other Health Information Management (HIM) related processes and policies. This position will primarily manage the Professional coding operations teams across the markets outside of California, but also operate at an enterprise level to help drive alignment across all markets.Essential Responsibilities:Accountable to develop and execute on short and long-term professional range Middle Revenue Cycle coding goals and objectives. Develop, lead, and deliver Professional, market-wide coding education via various avenues across the markets outside of California. Foster a positive, supportive, and inclusive work environment with clear strategies, plans, and objectives for: business goal attainment, ongoing coding improvement, excellence in performance, and quality aligned with national standards.Collaborate with enterprise and regional Professional coding and Middle Revenue Cycle leadership, Hospital CDI leaders, and revenue management leadership to support coding initiatives and attainment of goals such as coding QA. Facilitate Professional coding-related decision making and planning for key programs. Represent Professional coding leaders and participate in all required meetings including but not limited to Revenue Management Compliance, Middle Revenue Cycle, Hospital CDI, ICD-10, CAC, Quality and Core metrics, etc.Develop key market performance indicators (KPIs) to monitor performance on coding quality, accuracy, and completeness. Develop communication strategies and processes for communicating to coding team members as well as senior leadership. Communication needs to include success metrics, project updates, policy changes, system enhancements, etc. Organize, manage, assess, report, and monitor cost effective coding. Manage area of responsibility within budget authority. Maintain an ongoing process to identify, evaluate and implement cost restructuring activities to meet Professional coding mission and goals.Evaluate and plan for advanced technology to enhance the quality of coding. Maintain comprehensive knowledge of contemporary coding practices and emerging technology (clinical information systems) to ensure that Professional coding services and infrastructure are progressive and effective. Lead enterprise KP coding initiatives; working closely with leaders and project management staff in markets/regions - including, but not limited to, Computer Assisted Coding (CAC), ICD-10, CPT Codes, Recovery Audit Contractors Response (RAC) and other national initiatives (CPT Quality, Meaningful Use, ACOs, Core Measures). Promote that Professional coding operations are updated and compliant with all applicable regulatory changes and requirements, as well as with all applicable Kaiser Permanente policies and procedures in a timely and effective manner.Create and manage a strong culture across the markets outside of California that understand and support the Kaiser Permanentes vision and philosophy. Effectively lead geographically dispersed teams through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance. Ensure the recruitment, training, and retention of motivated, competent managers.QualificationsBasic Qualifications:ExperienceMinimum fifteen (15) years experience in the health information management (HIM) field, to include:Minimum twelve (12) years experience in a healthcare Coding leadership role, with a minimum five (5) years leadership experience in a vertically integrated and/or multi-facility health care system.Minimum ten (10) years coding experience working with MS-DRGs, APR-DRGs, APCs and HCCs.EducationBachelors Degree in Business Administration, Healthcare, Healthcare Information management (HIM) or related field, OR four (4) years of experience in a directly related field.High School Diploma or General Education Development (GED)License, Certification, RegistrationRegistered Health Information Technician Certificate OR Certified Coding Specialist OR Registered Health Information Administrator Certificate OR American Academy of Professional Coders Membership Additional Requirements:Demonstrated ability of completing initiatives and/or professional experience in the following areas:Analyzing, diagnosing, and resolving issues and interfacing with all stakeholders to identify and develop solutions;Change leadership, conflict resolution, group interaction and dynamics, project management, collaboration and facilitation of large-scale organizational transformation;Geographically diverse complex organization;Leading multidisciplinary, high-performance work teams/groups;Working with a variety of constituents;Expert knowledge in the following areas:CMS regulatory rules and coding guidelines;Complex project management processes, tools, techniques, and methodologies to lead large scale effort;Medical terminology, disease processes and pharmacology;Revenue Cycle processes.Must be able to work in a Labor/Management Partnership environment.Preferred Qualifications:Experience in analytics, data analysis, and quality programs.Experience with encoder and computer-assisted coding software.Previous experience using or implementing Epic or similar enterprise-wide revenue management technology/system.Masters degree in Business, Health Care Administration, Public Health, Information Technology, Finance, or other related filed.Job Field: Accounting, Finance and Actuarial ServicesJob Type: StandardSchedule: Full-timeJob Level: Director/Senior DirectorTravel: NoEmployee Status: Regular
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