Job details
Job type full-time
Full job description
Description:
The quality assurance (qa) manager 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 staffing, training, and providing development opportunitiesThe qa manager will deliver training from both an on-boarding and cross-training perspective and ensure staffing models are accurate based on volume and productivity expectations.
The qa manager will also assist with creation and provision of education back to tower teams, coding professionals, and other frontline staff based on quality output captured through case reviewsThe qa manager will collaborate with the following teams within accuity to ensure all of the trends identified are formalized into education and that the education gets delivered to the appropriate audiences: physician management, drg team management, inpatient coder management, query writing, query closure coding, and the accuity leadership team.
This position reports to the vp, revenue integrity.
Primary job responsibilities
Performs the quality assurance functions under the direction of the vp, revenue integrity and in accordance with the approved qa plan
Manages the quality program(s), policies, practices, and resources
Ensures compliance with external agencies including state and federal regulations for ethical coding and compliant queries
Maintains, and implements policies and procedures; evaluates and improves the effectiveness of policies, procedures and workflow
Coordinates work assignments of system wide qa staff and adjusts as needed based on schedules, volumes, and access
Monitors productivity levels and turn-around time
Assesses current qa personnel productivity standards and develops a strategic plan to improve organizational effectiveness
Maintains qa staff employee files, timecard approvals and tracks annual performance evaluations
Implements improvement measures that will enhance overall quality as well as client satisfaction
Supports the process and workflow, training, and education of the remote qa staff
Identifies 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 variance
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 integrity
Monitors the initiation, revision, and implementation of external regulations, statutes, and standards; facilitates implementation of revised regulations and ensures compliance
Organizes and analyzes trend data to be presented as an educational opportunity and/or used to drive process and outcome improvement initiatives
Analyzes internal quality reviews, makes recommendations for education, counseling, or termination for staff as appropriate
Reviews provisions for staff development, training, and orientations as prescribed by customers and any internal departmental standards
Performs miscellaneous job-related duties as assigned
Requirements:
Education:
Bachelor’s degree required
Graduate degree preferred
Clinical degree preferred
Certifications/credentials:
Ccs, cdip, or ccds required
Rhia, rhit or ccds-o preferred
Cphq, chq preferred
Six sigma or lean certifications preferred
Experience:
Minimum of 10 years of experience in the healthcare field
Experience in a related role or roles in revenue cycle, health information management, coding services, and/or clinical documentation improvement preferred
Demonstrated knowledge of both 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 and process-oriented approach
Recognizing, developing, and implementing coding and clinical documentation 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 and apply sound judgement
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, track and trend the audit results, and convert into applicable education
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
