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Coding & HIM Operations Process Director
Coding & HIM Operations Process DirectorKaiser Permanente • Pasadena, CA, US
Coding & HIM Operations Process Director

Coding & HIM Operations Process Director

Kaiser Permanente • Pasadena, CA, US
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  • [job_card.full_time]
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Coding & Him Operations Process Director

As part of the Strategic Transformation & Process Optimization team, you will drive strategic changes and optimization to enhance efficiency, effectiveness, and performance outcomes for our Revenue Cycle operational teams. We are part of the larger Enterprise Operations Support team, partnering with and providing support for end-to-end revenue cycle processes. As the Coding & HIM Ops Process Director, you will be responsible for HB coding, PB coding, HIM Ops, and CDI process management, driving standardization, best practice, and process excellence across the enterprise.

Oversees and directs team(s) of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive the implementation of successful business initiatives and projects. Directs the development and implementation of complex business initiatives, systems, and / or processes to a desired future state. Drives the development of business strategy and ensures alignment and prioritization of long-term organizational objectives and business initiatives. Oversees the management of complex projects or project components, directs large and complex change management plans, and directs team members in performing complex data analyses to drive business initiatives. Oversees vendor management as required. Monitors and takes accountability for the compliance of team work activities by ensuring business plans and team members adhere to relevant policies and procedures.

Essential Responsibilities :

  • Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
  • Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and / or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
  • Oversees and directs team(s) of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders and business owners to drive the implementation of successful business initiatives and projects across multiple functional tracks or complex workstreams by ensuring representation and inclusion of appropriate stakeholders; building rapport and partnerships with key stakeholder teams, third party vendors, and executive management; partnering with lead stakeholders to develop goals and set the prioritization of deliverables; driving business processes (e.g. project change management, communication) and setting the direction necessary for the delivery of business initiatives; communicating and resolving tough issues with stakeholders while preserving an independent perspective; and making formal presentations and providing reports to executive level audiences.
  • Directs the development of requirements for complex or specialized business, process, or system solutions spanning multiple business domain(s) by leveraging partnerships with key stakeholders and cross-functional teams as appropriate; providing guidance in the use of multiple business requirements gathering methodologies to identify business, functional, and non-functional requirements; and overseeing the development and documentation of comprehensive business cases to assess the costs, benefits, and ROI of proposed solutions.
  • Directs the development and implementation of complex business initiatives, systems, and / or processes to a desired future state by maintaining a comprehensive understanding of how current processes impact current and future business operations across multiple domains; identifying the operational impact of requirements on upstream and downstream solution components; providing options and recommendations to executive management and business stakeholders on how to integrate solutions and deliverables with current systems and processes across regions or domains to ensure growth; and directing the identification and validation of value gaps and opportunities for process enhancements or efficiencies.
  • Drives the development of business strategy and ensures alignment and prioritization of long-term organizational objectives and business initiatives by defining, developing, and evaluating performance metrics, standards, and methods to establish business success; partnering with executive stakeholders, often with competing / conflicting objectives, to ensure cohesive and reachable metrics; reviewing and refining strategic plans and performance metrics as appropriate; and overseeing a portfolio of diverse and complex initiatives to ensure delivery of measurable results and alignment with strategic objectives.
  • Serves as a lead advocate for continuous learning and professional development by keeping abreast of cutting edge industry practices, standards, and benchmarks; attending and presenting at roadshows, conferences, and speaking events; leading the ongoing enhancement and innovation of consulting practices, standards, and methods across KP; serving as an advocate to ensure continuous learning and improvement is championed as a people strategy; providing training and guidance to stakeholders as appropriate; and providing ongoing coaching to build a continuous improvement mindset and build capabilities that drive results.
  • Oversees the management of complex projects or project components by identifying and coordinating stakeholder contacts; assembling team based on project needs and team member strengths; monitoring the progress of developing, analyzing, and managing project plans; negotiating and managing project schedules and resource forecasts; managing project financials and deliverables; proactively monitoring and identifying project or business initiative risks, issues, and trigger events which may impact long-term organizational business objectives; developing mitigation plans and strategies; and resolving risks or issues as appropriate.
  • Directs large and complex change management plans associated with business initiatives by leveraging and developing stakeholder relationships to obtain support and buy-in for changes; partnering with executive management, project / program champions, and business owners to communicate and align improvement initiatives to set long-term business objectives; and empowering stakeholders to embrace a change management mindset, understand intent and purpose, and foster a culture of change.
  • Directs team members in performing complex data analyses to drive business initiatives by recommending appropriate data analysis tools and approach to assess business performance; determining suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; and identifying and alleviating risks through data-driven analysis.
  • Oversees vendor management as required by setting the standards for vendor performance levels; ensuring service level agreements are met; overseeing the management of vendor invoices; and partnering with rement and / or Legal to develop service level and / or scope of work agreements as appropriate.
  • Monitors and takes accountability for the compliance of team work activities by ensuring business plans and team members adhere to KP, departmental, and / or business line policies and procedures.

Minimum Qualifications :

  • Minimum three (3) years supervisory experience.
  • Bachelors degree from an accredited college or university and minimum ten (10) years experience in consulting, project management, data analytics, operations or a directly related field OR Masters degree in Business, Public Health, or a directly related field and minimum eight (8) years experience in consulting, project management, data analytics, operations or a directly related field OR minimum thirteen (13) years experience in consulting, project management, data analytics, operations or a directly related field.
  • Additional Requirements :

  • Knowledge, Skills, and Abilities (KSAs) : Business Acumen; Change Management; Negotiation; Creativity; Applied Data Analysis; Financial Acumen; Conflict Resolution; Managing Diverse Relationships; Process Validation; Project Management; Risk Assessment; Service Focus; Requirements Elicitation & Analysis
  • Preferred Qualifications :

  • Five (5) years of experience working with Medicare and Medicaid Duals.
  • Five (5) years of experience consulting in a large multi-hospital system.
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