VP, HCC Coding Quality and Strategic Initiatives
San Francisco, CA 
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Posted 14 days ago
Job Description

Datavant is a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. We are a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners.

By joining Datavant today, you're stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare. We hire for three traits: we want people who are smart, nice, and get things done. We invest in our people and believe in hiring for high-potential and humble individuals who can rapidly grow their responsibilities as the company scales. Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs.

VP of Coding Quality is responsible for the day-to-day operations of the Coding Department including client project mgmt., education and training, quality, and client relations. The VP plays a critical role in the development and execution of business strategy and compliance, overseeing the development, implementation and execution of Medicare advantage and Managed Medicaid risk adjustment strategy.

You will:

  • Creates and implements a quality program that sustains 97% quality or greater although innovative strategies with people, processes, and technologies.
  • Creates market-leading quality program to drives business wins.
  • Ensures smooth implementation of new technologies that drive higher quality and support the 97% quality goal by partnering with suppliers, product management, and engineering.
  • Considered the go-to Executive leader for quality related discussions and issues.
  • Is responsive to customer needs and anticipates problems and takes action to resolve them before they develop into significant customer dissatisfaction. Keeps the VP of Coding informed of customer issues.
  • Participates in client weekly meetings; is prepared to answer coding related questions and provide coding updates
  • Conducts weekly and monthly customer account review in regards to coding quality with all coding projects
  • Responds to customer concerns in a proactive, timely and professional manner and involves VP/GM as appropriate.
  • Provides performance data to customers once a month in person or via email to demonstrate our monthly performance including monthly volume, six-month trend of volume, latest quality audit scores and productivity. Include performance improvement action plans when appropriate.
  • Ensures that direct reports maintain established customer service standard, accuracy and productivity standards of team.
  • Assures that scheduling is completed monthly, customer requests are fulfilled, and coder bench remains at a minimum.
  • Facilitates employee requisition process and assures that adequate priority is placed on interviewing, testing and that employees meet the needs of the customer and required skill sets.
  • Collaborates with Division Auditors to schedule and implement internal coding audits on all consultants within parameters of appraisals and client requests.
  • Oversees quality assurance and performance improvement of employees and accounts as needed. Provides formal performance improvement and development plans when productivity or quality falls below standards.
  • Oversees and monitors customer facility operations. Works with Client Success and Development Liaisons and staff to achieve desired results on tasks performed, accuracy, productivity, and drives quality assurance and performance improvement as needed.
  • Responsible for the development of the employee education, driven by internal and client audit findings
  • Informs Sales of new business opportunities with existing customers and provides input that will assist sales partners and others as appropriate to pursue and close these opportunities.
  • Responsible for staying abreast of regulatory and pricing changes that will affect the financial and operational performance within his/her franchise.
  • On behalf of the Company, investigates and resolves matters of significance related to essential job functions. Works with customer and Client Success on jointly related issues as needed and appropriate.
  • Provides consultation and expert advice to coworkers and / or SVP in the areas of responsibility.
  • Completes required paperwork accurately, legibly and in a timely manner, including new hire paperwork, PTO, time punch edits & leave requests, expense reimbursements, client profile change forms, employee status changes, performance reviews, performance management, incident reports & incident investigation reports, separations from employment (including RIF & pre-discharge reports).
  • Follows all company and HR policies/procedures as outlined in the Employee & Supervisory Manuals.
  • Performs quality checks on all administrative work ensuring accuracy and completeness.
  • Responsible for upholding security and confidentiality regulations, and facility policies and procedures for access and review of all medical records.
  • Monitors new account start up in conjunction with Client Success.
  • Maintains professional growth and development by attending seminars and workshops and through professional affiliations.
  • Attends meetings with SVP as requested.
  • Performs other duties as needed or as directed.
  • Recruits and hires competent, qualified staff commensurate with defined job responsibilities.
  • Directs the work of subordinate employees, and is responsible for the advancement, promotion and other change of status of subordinate employees.
  • Provides staffing to ensure quality services according to contract agreements.
  • Maintains employee turnover within the franchise at or below corporate standard.
  • Ensures that staff is oriented, trained and the competency of staff is assessed (including but not limited to HIPAA), maintained, demonstrated and improved continually.
  • Conducts accurate, meaningful & timely performance appraisals; issues "kudos"; conducts performance improvement, progressive disciplinary action plans, and makes recommendations for discharge; and carries out all other personnel actions fairly and consistently, according to policies, procedures and laws/regulations.
  • Receives subordinates' call-ins, documents unplanned absences & takes appropriate action to provide coverage. Monitors pattern and rates of subordinates' unplanned absences and implements corrective action as needed according to Ciox policy.
  • Works to establish and facilitate effective employer - employee relations.
  • Follows up on and completes investigations into employee complaints, including HR in the process and informing chain-of-command as needed.
  • Delegates a responsible staff member to act in his/her behalf when he/she is absent. Informs designee on all issues relevant to the day's/week's operations.
  • Builds alignment by communicating and partnering effectively with co-workers in other departments to achieve franchise and company goals, mutual understanding of roles, and a positive work environment (including operations, sales, marketing, finance, human resources, information systems and others).
  • Establishes direction by defining an achievable path to realize the goals of the company.
  • Within franchise, ensures compliance with all appropriate regulations, including but not limited to HIPAA and labor regulations.
  • Works at appropriate level of independence and works within scope of position and direction. Demonstrates professionalism, and accuracy in completing responsibilities within deadlines.
  • Manages time, prioritizes and organizes work effectively.
  • Carries out responsibilities in accordance with Ciox policies and procedures, including Employee Handbook, Supervisory Manual, Training Manual, and Operations, Finance, Training and HR policies and procedures. Carries out responsibilities in accordance with applicable regulations, including HIPAA, state/federal regulations related to operations, and labor regulations.
  • Maintains confidentiality, security and standards of ethics with all Ciox information.
  • Demonstrates commitment to the job and Ciox. Willingly accepts responsibilities. Approaches change and difficult situations in a professional manner. Demonstrates flexibility.
  • Accurately reports days off & expense reimbursements according to established procedures.
  • Performs duties in a manner that assures maximum safety to self and others. Assists in keeping work area and equipment in safe working condition.
  • Initiates correction of hazards as appropriate and notifies others of hazards in a timely manner.
  • Ensures that direct reports and/or staff carry out their job responsibilities in a manner that assures maximum safety to self and others.
  • Investigates all incidents and implements a plan of correction, working closely with the People Team.

What you will bring to the table:

  • Bachelor' degree from an AHIMA certified HIM Program or Nursing Program.
  • Preferred CCS with an extensive coding background
  • Preferred Risk adjustment coding business experience
  • Excellent interpersonal and organizational skills required.
  • Experience and knowledge around use of NLP for best risk adjustment practices
  • Previous medical record experience required.
  • Minimum 5 years' experience in managerial role.
  • Excellent client and customer relations skills required.
  • Must have access to reliable transportation and a valid driver's license with a satisfactory driving record.
  • Experience with Microsoft Office Suite applications (Word, Excel, and Outlook) preferred.
  • Must be ambitious, accountable, flexible and mature and must conduct themselves professionally at all times.
  • Must communicate effectively at all levels inside and outside of the organization and express ideas and information clearly and concisely, in both verbal and written form.

We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks and industry best practices.

We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated salary range for this role is $154,000 - 200,000.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be anonymous and used to help us identify areas of improvement in our recruitment process. (We can only see aggregate responses, not individual responses. In fact, we aren't even able to see if you've responded or not.) Responding is your choice and it will not be used in any way in our hiring process.


We are committed to building a diverse team of Datavanters where every Datavanter is empowered to bring their authentic self to their work. We are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
5+ years
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