Copy - Professional Services - Quality Assurance Manager
Capstone Performance Systems, a subsidiary or Tabula Rasa Healthcare, is seeking
a QA Manager. This position performs highly technical and specialized functions for Capstone.
The Quality Assurance Team manager is responsible for the organizational, developmental, and
functional integrity of the quality assurance team; ensuring staff compliance, development, and
education. This position maintains a partnership with appropriate Company’s business
partner(s)ensure open lines of communication and facilitates and manages the
business relationship. The manager coordinates and supervises day to day operations within the quality
team, ensures compliance in maintaining a 95% coding and auditing accuracy standard for all coding
and auditing staff (internal and external) and ensures coding practices comply with recognized
standards. The manager is responsible for the security and accuracy of the patient record, which requires
remaining current with software and network security issues.
The manager will:
Manages the activities of QA Medical Coding Specialists and QA Auditing Specialists teams to ensure
compliance with departmental policies, standards, procedures and applicable regulatory requirements.Primary Liaison for Company’s business partner(s) managing and maintaining the partnership
including:Ensuring adherence to established processes and timely delivery
of product to Company.Supports contracting matters.
Leads joint quality improvement measures including timely
delivery of quality review findings, adherence to Company’s standards of
accuracy, consistency of communication among teams, and education/training
initiativesAudits, and validates vendor invoices
Ensures adherence to established staffing matrices, SLA’s, and
KPI’s of vendors.
Assists quality team, as needed, to complete work and ensure all expected standards in the process are working
optimally. Problem solves, troubleshoots and appropriately escalates issues to departmental management (as necessaryMonitors QA scores for internal and external coding and auditing.
Identifies trends in coding and auditing that require education and/or training for internal and external
coders and implements education and quality initiatives.Preparation and follow-up of action plans for coders and auditors falling below 95% accuracy.
Administers performance improvement and/or corrective action related to performance, attendance and
conduct.Determines efficient workflows and prioritizes case load to ensure fair work distribution
Collaborates with Coding Team Manager and Auditing Team Manager to provide feedback and establish action
plans as needed.Partners with Coding Team Manager and Auditing Team Manager to create a comprehensive team to support
clients, coders, and auditors.Develop, Maintain and/or update policies and procedures to ensure compliance across all processes.
Provides feedback and process improvement recommendations to appropriate teams and Director and
participates in workgroups/committee meetings and process improvement solutions
as required.Participates as requested in department meetings, client calls, and performance evaluation and management.
Provides floating coding coverage to fill in for PTO, backlogs and irregular projects.
Fosters and maintains collaborative work relationships among team members.
Performs other functions as required.
The successful candidate for this position will possess the following:
Bachelor’s Degree preferred; Associate Degree candidates will be considered: and Certified Registered
Nurse coder (CRN-C), Certified Coding Specialist designation (CCS) issued by the American Health Information
Management Association; or, Certified Professional Coder (CPC) or Registered Health Information Administrator
(RHIA), or Registered Health Information Technologist (RHIT)3+ years of risk adjustment coding experience.
3 years of relevant experience in a leadership role.
Proficiency with MS Word, Excel, PowerPoint, and comfortable becoming an expert on new and proprietary software.
Familiarity with computer operations, coder software
Highly skilled in written and verbal communication.
Has exceptional initiative and follow-through on projects with minimal supervision or guidance.
Refined interpersonal skills including a high level of emotional intelligence, reliability, and ability to work in a
team environment.Excellent people management skills and operational leadership skills, including collaboration with key stake holders
and senior leadership.Highly skilled at establishing priorities and coordinating work activities. Consistency, accuracy, promptness, and
adherence to productivity standards are of paramount importance.Experience in managing multiple teams with multiple objectives as well as establishing and
maintaining effective working relationships with clients.Strong sense of independence and ability to absorb new knowledge. Detail oriented, follows instructions and works with
minimal supervision with highly confidential information per HIPAA regulationsFamiliarity with computer operations, coder software
Highly skilled in written and verbal communication.
Has exceptional initiative and follow-through on projects with minimal supervision or guidance.
Refined interpersonal skills including a high level of emotional intelligence, reliability, and ability to work in a
team environment.Excellent people management skills and operational leadership skills, including collaboration with key stake holders
and senior leadership.Highly skilled at establishing priorities and coordinating work activities. Consistency, accuracy, promptness, and
adherence to productivity standards are of paramount importance.Experience in managing multiple teams with multiple objectives as well as establishing and
maintaining effective working relationships with clients.Strong sense of independence and ability to absorb new knowledge. Detail oriented, follows instructions and works with
minimal supervision with highly confidential information per HIPAA regulations
Other details
- Pay Type Salary