Senior Manager, Coding Quality Education & Training

Education

• Bachelor's Degree in Health Information Management, Healthcare Administration or a related field of study required

• Equivalent experience may be accepted in lieu of degree

Experience

• 3+ years of experience in medical coding or clinical documentation required

• 1+ years of experience in a supervisory or leadership role required

• 1+ years of experience in an educational or training preferred

Preferred qualifications include:

• American Health Information Management Association (AHIMA) credentials such as Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), and/or American Academy of Professional Coders (AAPC) credentials, such as CPC or other equivalent AAPC credential

Knowledge, Skills and Abilities

• Demonstrates competency and leadership experience in a large, complex organization with multiple locations.
• Drives DE&I (Diversity, Equity, & Inclusion) and recognizes the value that different perspectives and cultures bring to an organization.
• Clear understanding of the impact coding training and education has on Revenue Cycle operations and financial performance.
• Clear understanding of the impact the coding quality assurance program has on Revenue Cycle operations and financial performance.
• Excellent personnel management and organizational leadership skills - including written and oral communication, relationship management, customer service, and organization.
• Communicate and operate effectively within and between system functions.
• Craft, communicate, and align teams to the established departmental and enterprise vision, by using the capacity to simultaneously balance both the big picture strategic perspective and attention to detail.
• Act as an enthusiastic coach and leader with demonstrated ability to recruit, mentor, train and develop employees, and monitor performance.
• Manage upwards, elevating key risks and opportunity areas to Coding & Quality Leadership.
• Create and foster an atmosphere of continuous improvement.
• Manage and interpret data and analytics.
• Maintain an up-to-date knowledge of regulatory and compliance changes impacting Coding Quality and Quality Assurance.
• Guide and influence others either internally or externally to adopt a different point of view.

Principal Duties and Responsibilities:

• Implements the strategic direction for Quality, Education, & Training and collaborates with direct reports and functional leaders to drive alignment
• Establishes and oversees formal, comprehensive Revenue Cycle Training and Quality Assurance programs and policies designed to drive Revenue Cycle operational consistency, efficiency, and data-driven performance
• Stewards the continued development of training methodology and tools
• Reviews and coordinates all Quality Assurance and continuous value enhancement activities throughout the Revenue Cycle.
• Communicates and supervises relevant changes in performance, market trends, health care delivery systems, and legislative initiatives impacting execution of team goals to team(s).
• Partners with other organizational training and quality assurance teams, including Performance Excellence, to ensure an aligned and optimized learning experience for all Revenue Cycle teams and team members
• Implements and oversees strategies to measure, monitor, improve and validate coding and related data quality.
• Leads plans and priorities to address needs as identified by Coding teams to meet Enterprise Revenue Cycle goals.
• Identifies and solves technical and operational problems; understands and recognizes the broader impact of Coding Training and Quality Assurance activities in the Revenue Cycle.
• Identifies coding quality/education opportunities for clinical providers, departmental leaders and other stakeholders across the organization
• Drives and is responsible for consistent operational policies, processes, tools, educational and assessment materials.
  

Financial Performance

• Monitors and drives financial planning provided by leadership to support a cost-effective Coding Quality, Education, & Training Program.
• Designs and supervises financial and operational performance of a system-wide Coding Quality and Education program dedicated to ensuring proper documentation, accurate billing, compliant code assignment practices, and adherence to payor guidelines.
  

Operational Performance

• Manages day-to-day practice of multiple teams, including identification and monitoring of team success metrics and activities related to Coding Quality, Education, & Training.
• Establishes and supervises formal, comprehensive QA (Quality Assurance) / Training programs and operational policies designed to improve Coding operational consistency, efficiency, and data accuracy.
• Facilitates projects and conversations with outside health care organizations to share and develop standard processes.
• Supervises coding credentialing and certifications.
• Leads Coding Quality team to advise on coding guidance within the department (providing review, education, and feedback to coders) and also external to the department (inclusive of compiling and delivering physician education).
• Oversees and maintains a training curriculum to ensure coding professionals are educated on latest standards, regulations, and techniques in compliance with industry regulations and to accurately reflect revenue captured from clinical services provided.
• Collaborates with departmental leaders, Quality Management, clinical teams and providers to ensure coding accuracy.
• Measures and monitors coding quality and outcomes based on various reports.
  

Key Interactions

• Peer Coding & Quality Leadership | Support efficient, seamless deployment of Quality, Education, & Training services across HB (Hospital Billing) & PB (Professional Billing) Coding teams, via close interaction with Hospital & Professional Coding Leaders.
• External Partners | Maintains close relationships with external partners, such as regulatory and health information management associations, as needed to understand regulatory, compliance, and educational changes impacting Coding teams.
• Revenue Cycle Performance Excellence Team | Collaborate to find opportunities to align Coding Training & Education processes with overarching Revenue Cycle Training & Edu. Standards and best-practices.
• Vendor Strategy Team | Communicate Coding vendor performance considerations, and approach to vendor QA & education.
• Group Practice Management | Collaborate with GPM provider liaisons to understand opportunities for Education & Training sessions / specific needs of Providers and Site RC teams.
• Revenue Integrity | Support charge capture audit processes and feedback mechanisms.
• Compliance | Collaborate with Clinical Documentation Integrity and other compliance teams to provide enterprise-level feedback to Coding team.
• MGB Training Teams | Coordinate with enterprise-level training teams on training platforms, organizational standard processes, and training policies and procedures.

Decision Rights

Accountable

• Establish Coding-wide standards for Quality, Education, and Training.
  

Responsible

• Identify and Monitor Coding & Quality Key Performance Indicators (within Coding Quality, Education, & Training Team).
• Prioritize Coding & Quality Resources (within Coding Quality, Education & Training team, and including outside vendor support).
• Develop System-Wide Coding Related Technology Plans.
  

Consulted

• Design Coding & Quality Strategy.
• Define Coding & Quality Goals.
• Define Policies and Practices for the Coding & Quality Team.
• Establish Enterprise-Wide standards for Quality, Education, and Training.
• Develop Revenue Cycle Operational Budgets.
  

Informed

• Develop Enterprise-Wide Revenue Cycle Strategy.

Supervisory Responsibility:

• Approximately 15 direct reports

Fiscal Responsibility:

• Informed on development of RC Operational Budgets (for Coding & Quality Team).
• Demonstrates fiscal responsibility by effectively using Mass General Brigham resources.
  

Other duties and responsibilities as assigned.

Working Schedule:

• This position is remote with the expectation that leaders will come into the office, on average, once per quarter for up to 4 business days (travel will be reimbursed)