Operations Director, Audit Program

nnOur client, an expert, knowledge-based healthcare records release management firm and IT solution, is seeking an Operations Director, Audit Program.

The company”s leadership and team of advisers is a group of strategic thinkers working together to provide their clients with the tools, technology and professional support required to succeed in the ever-changing healthcare space.nn nn n nn nnThe Operations Director is responsible for directing the full lifecycle of medical record audit requests received from health insurance plans.

Our client partners with these organizations on their periodic audit of members enrolled in Medicare Advantage and Affordable Care Act health insurance.

nn nn n nn nnAs Operations Director of the Audit Program, you will lead a remote
– but highly coordinated
– team that communicates with internal and external clients (hospitals / healthcare facilities) and vendors to facilitate the successful completion of medical record audit requests.

This position is essential in facilitating the logistics of the full audit process from intake; to production planning; to processing requests; to releasing of records; and finally, payment.

This is a largely remote position with the expectation of travel when business needs require.

nn nn n nn nnIn this important logistics management role, you will:nn nn n nn Oversee the Audit Specialist team in executing on audit requests, this includes managing external vendors that support the team Lead the Medical Records Audit Department by shepherding incoming audit requests throughout their full lifecycle which includes: Client and Vendor communication, intake, production planning, processing, release, and finally payment Responsible for maintaining and building relationships with top Audit requestors, and attending weekly vendor calls addressing pipeline, production plan, payment status, and any issues Track and forecast completion dates of Audits and report weekly to senior management Forecast weekly and monthly volumes by detailed tracking of projects across clients and requestors that range from 10,000 chart requests to 1 chart, on the scale of 600,000 charts a year Create and maintain Audit request SOP/Best Practices, and work with training department to train Release of Information (ROI) staff to help process Audits Be the eyes and ears for the company on Audit pricing: managed care contracted rates, new Audit requestors, relationships between Audit requestors Partner with Operations to resolve issues including requestor fees Manage communications in a professional manner consistent with identified standards and metrics Maintain positive relationships with internal partners, clients, and requestors.

nn n nn nnQualifications for Operations Director:nn nn n nn Bachelor”s degree in Business/Operations/Healthcare Management preferred 5+ years of management experience (in a healthcare setting preferred) Strong logic & problem-solving skills and detail orientated Strong project management skills (PMP not required), including use of Gantt charts Ability to work effectively and independently in high volume & fast-paced environments Microsoft Excel: Intermediate to advanced skills required and desire to enhance skills through training SQL: Basic skills required (or willing to be taught/learn) to access large data sets Exceptional interpersonal skills and capacity to build effective relationships with co-workers and clients Strong level of patience to resolve issues and attentive to keep things on track nn n nn nn n nn nnWant to be part of an exciting, fast-paced, performance-oriented company that has doubled in size over the last year?

Send us your resume for consideration.

Our client”s staff of leading HIM, technology, finance, and sales professionals are passionate about their work and committed to fostering an environment that sparks innovation, collaboration and personal and professional development.

They offer a range of great benefits in support of their commitment to the health and well-being of employees and their families, and dedication to the industry they serve.nn nn n nn nn JustinBradley is an EO employer
– Veterans/Disabled and other protected categories.

nn nnby Jobblenn