Coding & Quality Manager

Description

At SCP Health, what you do matters

As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness.

With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.

Why you will love working here :

• Strong track record of providing excellent work / life balance
• Comprehensive benefits package and competitive compensation
• Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.

What you’ll be doing :

• Manage and monitor the LOTC process between EM and HM Quality Coding daily, in relation to productivity standards and metrics of both pre- and post-bill workflows.
• Manage and develop the key reports for daily productivity utilizing varies RCS and internal Quality tools to capture workflow for both EM and HM Quality volumes.
• Monitor volumes across all domains to include measures worked by offshore partners.
• Manage and monitor proficiency audits on all coders to ensure quality extracted data is accurate for operational reporting as well as registry submission.
• Manage and maintain training documents utilized for coding teams as well as documents for the providers and operational teams.
• Assist Director with the development, evaluations, and revisions of system edits, rules, and reports as needed to support Quality and Performance Excellence processes and procedures.
• Provide leadership, coaching and development for Quality Coding staff promoting open communication and collaboration.
• Assist Director with reporting solutions and analytical delivery methods to support quality and value care initiatives, business development, operational strategies, and client informational needs.
• Leverage advance knowledge of Quality Coding to manage and develop training and educational opportunities to elevate the quality of the Quality Coding team, leading them to exceptional results.
• Maintain a working relationship and communicate any system issues to the Athena, BI, and HIT teams.
• Maintain a working relationship and communicate any coding issues to the appropriate RCS teams.
• Maintain a working relationship and communicate any documentation issues to the appropriate Documentation Assurance team.
• Maintain a working relationship and communicate any Compliance issues to the Chief Compliance Officer.
• Perform and maintain a working knowledge of coding, extraction, auditing, validation, and other review processes.
• Provide ongoing guidance, training, and education as it relates to Compliance, MIPS, Value-Based and any other reviews performed to deliver quality services.
• Provide data and analytical support for Director and Vice President of Quality.
• Support ongoing guidance in troubleshooting system and quality data omissions to include but not limited to flow cast issues, coding omissions, and other problematic processes with billing and coding that impact the quality data code submission and extraction process.
• Support ongoing guidance in troubleshooting system wide operational reports to confirm data, reporting, or other data concerns.
• Provide ongoing guidance regarding workflow optimization and volume reporting and analysis of daily throughput.
• Support ongoing guidance regarding data integrity supporting medical leadership and operations teams on data elements reported through varies systems.
• Performs and administers performance appraisals of Quality Coding staff.
• Performs review and stays updated on regulatory guidelines and specification manuals supporting MIPS, value-based, and any other quality services determined by medical leadership.
• Supports Director and VP of Quality with making recommendations for continuing training and meetings for Quality team.
• Perform other duties and assist with additional projects as may be deemed necessary or required.

Who / What we are looking for :

• Certified / licensed clinician or BS / BA
• RN, BSN, and / or RHIA
• Minimum of five years healthcare coding or hospital experience preferred.
• Minimum of three to five years process improvement, core measure / quality metric, or clinical audit experience
• Minimum five years full-time coding experience.
• Supervisory experience required; three years minimum.

SCP Health and its affiliated companies (collectively, SCP Health ) require applicants for specific positions, such as those onsite at a client company / healthcare facility or affiliate to be vaccinated against COVID-19 as a condition of employment, except where prohibited by state or local law.

To demonstrate compliance with SCP Health’s vaccination policy, proof of COVID-19 vaccination status will be requested upon a conditional offer of employment for onsite positions at a client company / healthcare facility.

SCP health will consider religious and / or medical / disability accommodation and other legally required exemption request as required by applicable law.

To learn more about SCP Health, please visit : Join our social circle : SCP Health is an Equal Opportunity Employer.

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