Director of Quality Improvement

About the role: Director Quality and Process Improvements

Responsibilities:

Lead Revenue Cycle Quality Assurance and Continuous Improvement initiatives

Process Improvement Strategy development as a Thought Leader

Act as a change agent to help establish common goals and create alliances with Operations to optimize success.

Run an outcome-based quality program and as an offering for profit function.

Drives the most complex revenue cycle improvement opportunities. This may include opportunities that span multiple clients, multiple service lines, or have complex change management or learning impacts and influences enterprise alignment of people, process, and technology.

Identify opportunities for improving Revenue Cycle performance and metrics associated with insurance collections, Days in Accounts Receivable, Aging of Accounts Receivable, Clean Claim Rate, Denial Percentage, and avoidable write-offs.

Maintain working knowledge of billing guidelines, CMS updates, and other industry dynamics.

Work with Training in creating a process for transforming quality findings into continuous knowledge improvement of the associates.

Introduce and inculcate Lean Six Signa approach for problem solving.

Ensures organization delivers quality services in accordance with applicable policies, procedures, and professional standards.

Focus on employee training and development, prepare, and implement developmental plans for auditors.

Optimize resource utilization; QA: FTE, Manage hiring / staffing requirements.

Experience:

Minimum 18 Years of Experience in BPO/ITES managing Quality Assurance, Process Improvement, with 10 years experience in RCM/US healthcare is preferred.

Minimum Qualification:

Graduation

Certification in Lean Six Sigma (Black Belt) is preferred

Key Competencies:

Analytical Skills - Mathematical / Analytical aptitude, ability to translate concepts into measurable results.

Problem Solving - This role will require getting deep into details and personally driving results in complex and challenging environments.

Strong communications and leadership skills, while acting as a role model and coaching team members on Organization's core values

Interpersonal Skills - The ability to establish oneself as a peer and trusted partner for operations leaders and onshore counterparts.

Proficiency with Microsoft Office Suite, Visio and analytical tools like Minitab, Tableau.

Strong domain understanding of US healthcare (Payer/Provider); Provider experience preferred; Payer experience is acceptable as well