Director, Quality Assurance

DescriptionPOSITION SUMMARY:The Director, Quality Assurance is responsible for providing oversight and leadership to the Quality Assurance (QA) Specialist team, which includes but is not limited to, interviewing for and selecting staff, training, and providing development opportunities. The Director, Quality Assurance will identify training needs and deliver training from both an on-boarding and cross-training perspective. The Director, Quality Assurance will also ensure staffing models and team structure are accurate based on volume and productivity expectations.The Director, Quality Assurance will also assist with streamlining and standardizing the creation and provision of education back to the Quality Assurance Specialist team, Tower teams, coding professionals, and other frontline staff based on quality output captured through acute inpatient audits. The Director, Quality Assurance will collaborate with the following teams within Accuity to ensure all of the trends identified are formalized into feedback and education to the appropriate audiences: Physician Management, DRG Team Management, Inpatient Coder Management, Query Writing, Query Closure Coding, Escalation team, clients and the Accuity leadership team.PRIMARY JOB RESPONSIBILITIES:Performs the quality assurance leadership functions under the direction of the Vice President of DRG Integrity and in accordance with the approved QA planDirects the management of the quality program(s), policies, practices, and resourcesCoordinates work assignments of system wide QA staff and adjusts as needed based on schedules, volumes, and accessManages the QA team quality, monitors productivity levels and turn-around timesAssesses current QA personnel productivity standards and develops a strategic plan to improve organizational effectivenessOversees QA staff employee files, timecard approvals and tracks performance information to successfully provide feedback and complete annual performance evaluationsImplements improvement measures that will enhance overall quality as well as client satisfactionDesigns and develops QA curriculum, programs, learning materials, and collateral based on industry design standardsIdentifies patterns, trends, and variations in coding and other types of data and takes appropriate steps in collaboration with appropriate departments to affect resolution or explanation of the varianceCollaborates with team leadership within Accuity to generate educational opportunities needed to support coding compliance, improve accuracy, and ensure variance in coding practices.Ensures that information systems support current and future needs of the department by working closely with the Technology team in transition planning including but not limited to; testing, installation, and education of staff to produce and maintain high quality coding and data integrityOrganizes and analyzes trend data to be presented as an educational opportunity and/or used to drive process and outcome improvement initiativesAssigns Learning Management System (LMS) modules for the QA team and coordinating technology matters with IT LMS administratorsEvaluates modes of training delivery to optimize training effectiveness and efficiencyCreates ICQ goals and works with Human Resources and others to create development/training plans for the teamAnalyzes internal quality reviews, makes recommendations for education, counseling, or termination for staff as appropriateDirects provisions for staff development, training, and orientations as prescribed by customers and any internal departmental standardsEnsures compliance with external agencies including state and federal regulations for ethical coding and compliant queriesDirects the initiation, revision, and implementation of external regulations, statutes, and standards; facilitates implementation of revised regulations and ensures complianceStay abreast of industry trends and developments to ensure that coding and auditing services remain competitive and relevant.Research complex inpatient coding issues related to questions from Accuity staff and works to find a resolution.Performs miscellaneous job-related duties as assignedRequirementsPOSITION QUALIFICATIONS:Education :Bachelor's or Graduate degree in Healthcare Administration, Health Information Management or other related field(s) preferredAssociate's degree in Healthcare Administration, Health Information Management or other related field(s) requiredCertifications/Credentials:Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC or CIC)CDIP or CCDS preferredAHIMA ICD-10/PCS trainer certification preferredExperience:Minimum of 10 years of recent experience in the Health Information Management (HIM) field requiredMinimum of 5 years Inpatient coding experience requiredMinimum of 5 years of experience in inpatient coding auditing requiredExperience in the preparation and presentation of education related to audit findingsExtensive knowledge of Coding Compliance and Standards for Ethical CodingExtensive knowledge in a related role or roles in revenue cycle, health information management, coding services, and inpatient auditing.Demonstrated knowledge of both MS and APR-DRG models, ICD-10-CM, and ICD-10-PCSDemonstrated knowledge of computer technology and preferred knowledge of MS Office including Word, Excel, and PowerPointKnowledge, Skills, and Abilities:Preference for action with a solution, process-oriented, and data driven approachRecognizing, developing, and implementing coding best practicesHighly motivated, self-directed, and able to work independently with minimal supervisionAnalytical ability to gather and interpret data to identify areas of opportunity, problems, or issues and apply sound judgementEffective at managing team and individual performanceLeadership skills that demonstrate accountability, decision-making, coaching and counselingExperience in conflict management and problem resolutionAbility to interpret coding quality audit data, track and trend the audit results, and convert into applicable educationAbility to consistently and accurately audit coding of inpatient encountersGood interpersonal and customer service skills with a client focusStrong written and verbal skillsExperience with electronic health records and health information systemsAbility to organize and set priorities to ensure that objectives are met in a timely mannerAbility to establish and maintain cooperative working relationships with staff at every level of the organizationIndependent, focused individual able to work remotely