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The Director, Operational Excellence will lead strategic initiatives to enhance the efficiency, accuracy, and compliance of medical coding operations across the organization. This role is responsible for driving continuous improvement, ensuring regulatory alignment, and fostering a high-performance culture within coding teams. The ideal candidate is a seasoned leader with deep expertise in medical coding, risk adjustment, and operational transformation.

Key Responsibilities

Strategy:

• Develop and execute a roadmap for operational excellence in medical coding.
• Align coding operations with organizational goals, regulatory requirements, and industry best practices.
• Oversee performance of Coding Educators and Program Managers supporting consultative, onshore, and offshore coding teams.

Quality and Compliance:

• Oversee coding quality assurance programs to ensure accuracy and compliance with CMS, HHS, and other regulatory bodies.
• Monitor audit outcomes and implement corrective actions and targeted training programs.

Process Optimization:

• Manage and mentor Coding Educators and Program Managers.
• Promote a culture of accountability, continuous learning, and operational excellence.

Team Development:

• Manage and mentor a team of coding educators and program managers.
• Foster a culture of accountability, continuous learning, and performance excellence.

Cross-Functional Collaboration:

• Partner with clinical, analytics, and compliance teams to support coding initiatives.
• Serve as a subject matter expert in coding operations for cross-departmental projects.

Reporting & Analytics:

• Develop and maintain dashboards and KPIs to monitor coding performance and operational metrics.
• Present insights and recommendations to senior leadership.

Coder Education:

• Collaborate with the training organization to design and deliver comprehensive training programs based on audit findings.
• Partner with analytics and audit teams to identify coder errors and address skill gaps.

Associate Engagement and Retention:

• Foster a positive work environment that encourages collaboration, innovation, and personal growth.
• Conduct regular feedback sessions, performance evaluations, and career development discussions.
• Address employee concerns, resolve conflicts, and implement initiatives to improve satisfaction and retention.

Use your skills to make an impact
 

Minimum Qualifications:

• Bachelor’s degree required
• Minimum of five (5) years of progressive experience in operational excellence, medical coding operations, or a related healthcare leadership role.
• Minimum of five (5) years leadership experience overseeing multifaceted teams
• Experience in program management and analytics

Preferred Certifications:

• Master’s degree preferred.
• Deep understanding of ICD-10, CPT, and HCPCS coding, with expertise in navigating CMS and HHS regulations.
• CPC, CCS, or other relevant medical coding certifications preferred

Required Experience & Skills:

• Demonstrated experience developing and executing operational strategies within medical coding or healthcare operations.
• Proven ability to align coding operations with organizational objectives, regulatory requirements (e.g., CMS, HHS), and industry best practices.
• Track record of leading, managing, and mentoring teams, including Coding Educators and Program Managers, across consultative, onshore, and offshore environments.
• Experience overseeing coding quality assurance programs and implementing corrective actions and targeted training based on audit outcomes.
• Strong background in process optimization and promoting a culture of accountability, continuous learning, and operational excellence.
• Ability to foster team development, drive performance, and support associate engagement and retention.
• Experience collaborating cross-functionally with clinical, analytics, and compliance teams, and acting as a subject matter expert for coding operations.
• Proficiency in developing and maintaining dashboards, KPI