Accuity
Director, Quality Assurance
Accuity, Los Angeles, California, United States, 90079
Job Type
Full-time
Description POSITION SUMMARY: The Director, Quality Assurance is responsible for providing oversight and leadership to the Quality Assurance (QA) Specialist team. This includes interviewing for and selecting staff, training, and providing development opportunities. The Director will identify training needs and deliver training from both an onboarding and cross-training perspective. Additionally, the Director will ensure staffing models and team structure are accurate based on volume and productivity expectations. The Director will assist with streamlining and standardizing the creation and provision of education back to the QA Specialist team, Tower teams, coding professionals, and other frontline staff based on quality output captured through acute inpatient audits. The Director will collaborate with various teams within Accuity to ensure all 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: Perform quality assurance leadership functions under the direction of the Vice President of DRG Integrity and in accordance with the approved QA plan. Direct the management of the quality program(s), policies, practices, and resources. Coordinate work assignments of system-wide QA staff and adjust as needed based on schedules, volumes, and access. Manage QA team quality, monitor productivity levels, and turnaround times. Assess current QA personnel productivity standards and develop a strategic plan to improve organizational effectiveness. Oversee QA staff employee files, timecard approvals, and track performance information. Implement improvement measures that will enhance overall quality as well as client satisfaction. Design and develop QA curriculum, programs, learning materials, and collateral based on industry design standards. Identify patterns, trends, and variations in coding and other types of data and take appropriate steps to affect resolution. Collaborate with team leadership within Accuity to generate educational opportunities needed to support coding compliance and improve accuracy. Ensure that information systems support current and future needs of the department by working closely with the Technology team. Organize and analyze trend data to be presented as an educational opportunity and/or used to drive process and outcome improvement initiatives. Assign Learning Management System (LMS) modules for the QA team and coordinate technology matters with IT LMS administrators. Evaluate modes of training delivery to optimize training effectiveness and efficiency. Create ICQ goals and work with Human Resources to create development/training plans for the team. Analyze internal quality reviews and make recommendations for education, counseling, or termination for staff as appropriate. Direct provisions for staff development, training, and orientations as prescribed by customers and internal standards. Ensure compliance with external agencies including state and federal regulations for ethical coding and compliant queries. Direct the initiation, revision, and implementation of external regulations, statutes, and standards. Stay abreast of industry trends and developments to ensure coding and auditing services remain competitive. Research complex inpatient coding issues related to questions from Accuity staff and work to find a resolution. Perform miscellaneous job-related duties as assigned.
Requirements POSITION QUALIFICATIONS: Education: Bachelor's or Graduate degree in Healthcare Administration, Health Information Management or related field(s) preferred. Associate's degree in Healthcare Administration, Health Information Management or related field(s) required. Certifications/Credentials: Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC or CIC). CDIP or CCDS preferred. AHIMA ICD-10/PCS trainer certification preferred. Experience: Minimum of 10 years of recent experience in the Health Information Management (HIM) field required. Minimum of 5 years inpatient coding experience required. Minimum of 5 years of experience in inpatient coding auditing required. Experience in the preparation and presentation of education related to audit findings. Extensive knowledge of Coding Compliance and Standards for Ethical Coding. Demonstrated knowledge of MS and APR-DRG models, ICD-10-CM, and ICD-10-PCS. Demonstrated knowledge of computer technology and preferred knowledge of MS Office including Word, Excel, and PowerPoint. Knowledge, Skills, and Abilities: Preference for action with a solution, process-oriented, and data-driven approach. Recognizing, developing, and implementing coding best practices. Highly motivated, self-directed, and able to work independently with minimal supervision. Analytical ability to gather and interpret data to identify areas of opportunity, problems, or issues. Effective at managing team and individual performance. Leadership skills that demonstrate accountability, decision-making, coaching, and counseling. Experience in conflict management and problem resolution. Ability to interpret coding quality audit data and convert into applicable education. Ability to consistently and accurately audit coding of inpatient encounters. Good interpersonal and customer service skills with a client focus. Strong written and verbal skills. Experience with electronic health records and health information systems. Ability to organize and set priorities to ensure that objectives are met in a timely manner. Ability to establish and maintain cooperative working relationships with staff at every level of the organization. Independent, focused individual able to work remotely.
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Description POSITION SUMMARY: The Director, Quality Assurance is responsible for providing oversight and leadership to the Quality Assurance (QA) Specialist team. This includes interviewing for and selecting staff, training, and providing development opportunities. The Director will identify training needs and deliver training from both an onboarding and cross-training perspective. Additionally, the Director will ensure staffing models and team structure are accurate based on volume and productivity expectations. The Director will assist with streamlining and standardizing the creation and provision of education back to the QA Specialist team, Tower teams, coding professionals, and other frontline staff based on quality output captured through acute inpatient audits. The Director will collaborate with various teams within Accuity to ensure all 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: Perform quality assurance leadership functions under the direction of the Vice President of DRG Integrity and in accordance with the approved QA plan. Direct the management of the quality program(s), policies, practices, and resources. Coordinate work assignments of system-wide QA staff and adjust as needed based on schedules, volumes, and access. Manage QA team quality, monitor productivity levels, and turnaround times. Assess current QA personnel productivity standards and develop a strategic plan to improve organizational effectiveness. Oversee QA staff employee files, timecard approvals, and track performance information. Implement improvement measures that will enhance overall quality as well as client satisfaction. Design and develop QA curriculum, programs, learning materials, and collateral based on industry design standards. Identify patterns, trends, and variations in coding and other types of data and take appropriate steps to affect resolution. Collaborate with team leadership within Accuity to generate educational opportunities needed to support coding compliance and improve accuracy. Ensure that information systems support current and future needs of the department by working closely with the Technology team. Organize and analyze trend data to be presented as an educational opportunity and/or used to drive process and outcome improvement initiatives. Assign Learning Management System (LMS) modules for the QA team and coordinate technology matters with IT LMS administrators. Evaluate modes of training delivery to optimize training effectiveness and efficiency. Create ICQ goals and work with Human Resources to create development/training plans for the team. Analyze internal quality reviews and make recommendations for education, counseling, or termination for staff as appropriate. Direct provisions for staff development, training, and orientations as prescribed by customers and internal standards. Ensure compliance with external agencies including state and federal regulations for ethical coding and compliant queries. Direct the initiation, revision, and implementation of external regulations, statutes, and standards. Stay abreast of industry trends and developments to ensure coding and auditing services remain competitive. Research complex inpatient coding issues related to questions from Accuity staff and work to find a resolution. Perform miscellaneous job-related duties as assigned.
Requirements POSITION QUALIFICATIONS: Education: Bachelor's or Graduate degree in Healthcare Administration, Health Information Management or related field(s) preferred. Associate's degree in Healthcare Administration, Health Information Management or related field(s) required. Certifications/Credentials: Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC or CIC). CDIP or CCDS preferred. AHIMA ICD-10/PCS trainer certification preferred. Experience: Minimum of 10 years of recent experience in the Health Information Management (HIM) field required. Minimum of 5 years inpatient coding experience required. Minimum of 5 years of experience in inpatient coding auditing required. Experience in the preparation and presentation of education related to audit findings. Extensive knowledge of Coding Compliance and Standards for Ethical Coding. Demonstrated knowledge of MS and APR-DRG models, ICD-10-CM, and ICD-10-PCS. Demonstrated knowledge of computer technology and preferred knowledge of MS Office including Word, Excel, and PowerPoint. Knowledge, Skills, and Abilities: Preference for action with a solution, process-oriented, and data-driven approach. Recognizing, developing, and implementing coding best practices. Highly motivated, self-directed, and able to work independently with minimal supervision. Analytical ability to gather and interpret data to identify areas of opportunity, problems, or issues. Effective at managing team and individual performance. Leadership skills that demonstrate accountability, decision-making, coaching, and counseling. Experience in conflict management and problem resolution. Ability to interpret coding quality audit data and convert into applicable education. Ability to consistently and accurately audit coding of inpatient encounters. Good interpersonal and customer service skills with a client focus. Strong written and verbal skills. Experience with electronic health records and health information systems. Ability to organize and set priorities to ensure that objectives are met in a timely manner. Ability to establish and maintain cooperative working relationships with staff at every level of the organization. Independent, focused individual able to work remotely.
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