Talent.com
Program Management Lead, Offshore Coding Operations
Program Management Lead, Offshore Coding OperationsOhio Staffing • Columbus, OH, US
No se aceptan más aplicaciones
Program Management Lead, Offshore Coding Operations

Program Management Lead, Offshore Coding Operations

Ohio Staffing • Columbus, OH, US
Hace 6 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Program Management Lead, Offshore Coding Operations

Become a part of our caring community and help us put health first. The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical records and ICD-9 / 10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore Coding Operations works on problems of diverse scope and complexity ranging from moderate to substantial. The Program Management Lead, Offshore Coding Operations optimizes the effectiveness of the offshore coding (post-visit) team. The lead analyzes the performance of the offshore coding team and creates strategies to maximize associate output.

Relationship Building :

  • Cultivate relationships with onshore and offshore coding teams including leaders.
  • Serve as liaison and primary point of contact with the offshore (vendor) leaders.
  • Strategy : Advises coding leaders to develop functional strategies (often segment specific) on matters of significance.
  • In partnership with Coding Operational Excellence and Regional Coding Leaders, develop strategies for continuous improvement of offshore coding processes and quality.

Qualitative and Quantitative Analyses :

  • Analyze trends and share results with coding leaders / teams.
  • Monitor quality and address performance gaps.
  • Research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.
  • May participate in coder education programs on coding compliance.
  • Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records.
  • Mergers and Acquisitions :

  • Partner with coding teams (consultative coders) on the special handling of Mergers & Acquisitions.
  • Other Duties :

  • Lead Special Projects for onshore and offshore coding teams.
  • Participate in chart reviews to identify educational opportunities.
  • Conduct research as needed.
  • Participate in Payer calls / chart reviews.
  • May participate in provider education programs on coding compliance.
  • Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.
  • Required Qualifications

  • Bachelor's degree in a relevant field (e.g., Health Information Management, Business Administration, Healthcare Administration)
  • Active professional certification required : CCS, CRC, or CPC
  • Minimum 5 years' progressive experience in medical coding operations
  • Minimum of 3 years' direct experience managing or optimizing offshore coding teams and vendor partnerships
  • Demonstrated success leading cross-functional initiatives and continuous improvement efforts in large, matrixed healthcare organizations
  • Experience collaborating with analytics, training, and operational excellence teams to drive quality and efficiency in coding workflows
  • Prior exposure to supporting mergers & acquisitions in a coding operations context preferred
  • Preferred Qualifications

  • Master's degree preferred.
  • Active professional certification : RHIA, RHIT
  • Knowledge, Skills, and Abilities

  • Advanced understanding of medical coding guidelines, healthcare regulations (including HIPAA, state and federal compliance), and payer requirements
  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and relevant coding / audit software
  • Strong business acumen with proven strategic and critical thinking skills
  • Ability to analyze complex quantitative and qualitative data, synthesize findings, and communicate actionable insights to leadership
  • Outstanding verbal and written communication skills, with the ability to present to and influence diverse stakeholder groups
  • Effective relationship-building skills with both onshore and offshore teams, including vendor management and leadership liaison
  • Proven ability to work successfully in a fast-paced, dynamic, and matrixed environment
  • Commitment to continuous improvement, operational excellence, and collaborative problem-solving
  • Public speaking and group presentation experience required
  • Demonstrated ability to educate and mentor staff on coding compliance and best practices
  • Additional Information

  • Preferred work hours : EST
  • Up to 20% travel nationally within CenterWell markets
  • Work at Home Requirements

  • To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria :
  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
  • Satellite, cellular and microwave connection can be used only if approved by leadership
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home / Office employees with telephone equipment appropriate to meet the business requirements for their position / job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
  • Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
  • Scheduled Weekly Hours

    40

    Pay Range

    The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,000 - $143,000 per year

    Description of Benefits

    Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

    About Us

    About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.

    About CenterWell, a Humana company : CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

    Equal Opportunity Employer

    It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https : / / www.partnersinprimarycare.com / accessibility-resources

    Crear una alerta de empleo para esta búsqueda

    Program Management Lead Offshore Coding Operations • Columbus, OH, US

    Ofertas similares
    Program Manager (Hypercare)

    Program Manager (Hypercare)

    ComResource • Columbus, OH, US
    A tiempo completo
    ComResource is looking for a Program Manager (Hypercare).We need someone to assist in leading post–go-live support efforts by coordinating issue management, driving resolution, and ensuring a...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Operations Lead

    Operations Lead

    VirtualVocations • Columbus, Ohio, United States
    A tiempo completo
    A company is looking for an Operations Lead for a 10-month remote position.Key Responsibilities : Oversee daily operational workflows, including request intake, compliance checks, and troubleshoot...Mostrar más
    Última actualización: hace 1 día • Oferta promocionada
    Total Rewards Program Lead

    Total Rewards Program Lead

    Social Solutions Global • Columbus, OH, United States
    A tiempo completo
    Bonterra exists to propel every doer of good to their peak impact.We measure that impact against our vision to increase the giving rate as a percentage of GDP from 2% to 3% by 2033.We know that thi...Mostrar más
    Última actualización: hace 8 días • Oferta promocionada
    Data Center Portfolio Manager, Strategic Initiatives

    Data Center Portfolio Manager, Strategic Initiatives

    Amazon Data Services, Inc. • Columbus, OH, US
    A tiempo completo
    AWS Infrastructure Services owns the design, planning, delivery, and operation of all AWS global infrastructure.In other words, we're the people who keep the cloud running.We support all AWS data c...Mostrar más
    Última actualización: hace 1 día • Oferta promocionada
    Director, Software Engineering

    Director, Software Engineering

    Highlights for Children • Columbus, OH, United States
    A tiempo completo
    Director of Software Engineering.The Director of Software Engineering is responsible for end-to-end digital delivery and reliability, overseeing software engineering, DevOps and platform operations...Mostrar más
    Última actualización: hace 3 días • Oferta promocionada
    Director, Large Program Execution

    Director, Large Program Execution

    Vertiv Holdings • Westerville, OH, US
    A tiempo completo
    Director, Large Program Execution.The Director, Large Program Execution functions as the top-level orchestrator of complex, multi-region customer programs ensuring all Business Units (Power, IS, T...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Operations Lead

    Operations Lead

    InsideHigherEd • Columbus, Ohio, United States
    A tiempo completo
    Screen reader users may encounter difficulty with this site.For assistance with applying, please contact.If you have questions while submitting an application, please review these.Current Employees...Mostrar más
    Última actualización: hace 4 días • Oferta promocionada
    Director of Large Program Execution

    Director of Large Program Execution

    Blue Star Partners LLC • Columbus, OH, US
    A tiempo completo
    Director of Large Program Execution.Now through 12 / 31 / 2026 (Strong possibility of extension).W-2 available with 401(k) match at rate of $147 / hr). Citizens only (No sponsorship or visa support).The D...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Absence Management Team Lead - Coding Team

    Absence Management Team Lead - Coding Team

    Sedgwick • Dublin, OH, US
    A tiempo completo
    Absence Management Team Lead - Coding Team.By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing ...Mostrar más
    Última actualización: hace 11 días • Oferta promocionada
    Senior Technical Program Manager - Cloud Infrastructure

    Senior Technical Program Manager - Cloud Infrastructure

    Oracle • Columbus, OH, United States
    A tiempo completo
    Oracle Cloud Infrastructure (OCI).Technical Program Manager to effectively operationalize contract terms for GPU and cloud agreements. In this role, you will have the opportunity to translate contra...Mostrar más
    Última actualización: hace 6 días • Oferta promocionada
    Sr. Director, Compute Category Management

    Sr. Director, Compute Category Management

    Hewlett Packard Enterprise • Columbus, OH, US
    A tiempo completo
    Director, Compute Category Management.This role has been designated as 'Remote / Teleworker', which means you will primarily work from home. Who We Are : Hewlett Packard Enterprise is the global edge-t...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Data Center Program Manager

    Data Center Program Manager

    GAI Consultants Inc. • Columbus, OH, United States
    A tiempo completo
    We are seeking a strategic and experienced.Data Center Project / Program Manager.This role combines technical leadership, client engagement, and team development with a forward-thinking approach to i...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Oncology Informatics Manager, Clinical Operations

    Oncology Informatics Manager, Clinical Operations

    Massive Bio • Columbus, OH, US
    A tiempo completo
    Massive Bio is a rapidly growing health-tech startup founded in 2015 to provide every cancer patient with access to clinical trials regardless of their location or financial stability.Our proprieta...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Technical Program Manager

    Technical Program Manager

    T-Cetra LLC • Dublin, OH, US
    A tiempo completo
    Reports to : Principal Technical Program Manager.Location : Hybrid - Dublin, Ohio (3 days) Remote (2 days).We're constantly developing new and creative ways to solve the industry’s most com...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada
    Enterprise Automation Lead

    Enterprise Automation Lead

    Manifest Solutions • Columbus, OH, US
    A tiempo completo
    Manifest Solutions is currently seeking an Enterprise Automation Lead for a position in Columbus, OH.Act as the technical subject matter expert (SME) in Tosca Automation and related testing methodo...Mostrar más
    Última actualización: hace 1 día • Oferta promocionada
    Senior Principal Technical Program Manager (Cloud Infrastructure)

    Senior Principal Technical Program Manager (Cloud Infrastructure)

    Oracle • Columbus, OH, United States
    A tiempo completo
    At Oracle Cloud Infrastructure (OCI), we are at the forefront of innovation in cloud technology for enterprises.Our dynamic team embodies the spirit of a start-up, while delivering the reliability ...Mostrar más
    Última actualización: hace 20 días • Oferta promocionada
    Sr. Technical Program Manager, Enterprise Apps

    Sr. Technical Program Manager, Enterprise Apps

    Coinbase • Columbus, OH, United States
    A tiempo completo
    Ready to be pushed beyond what you think you’re capable of?.At Coinbase, our mission is to increase economic freedom in the world. It’s a massive, ambitious opportunity that demands the best of us, ...Mostrar más
    Última actualización: hace 10 días • Oferta promocionada
    Manager, Enterprise Apps, Tech Ops

    Manager, Enterprise Apps, Tech Ops

    Columbus Staffing • Columbus, OH, US
    A tiempo completo
    Japan with operations in the U.With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bri...Mostrar más
    Última actualización: hace más de 30 días • Oferta promocionada