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In-patient Medical Coding Manager
Home Office
Opportunity Snapshot
This is a hands-on leadership opportunity to make a ground floor impact on an exciting new contract. Spearheading all aspects of the Inpatient Hospital DRG Review Contract with the Illinois Department of Healthcare and Family Services (HFS), you will navigate staff and resources through the entire project life-cycle as you expertly manage costs and deliverables. This will include everything from conducting a thorough needs assessment to figuring out the final deliverables to developing the timelines, conducting in-patient coding audits and collaborating closely with both HFS and the providers (up to 27 hospitals by end of 2010) to develop the processes and procedures to make this project happen.
To be a good fit for this opportunity you will have an RHIA certification along with three years of experience as a coder in the area of DRG validation and ICD-9 coding. Of course, as in any startup project involving multiple stakeholders, you will also have the interpersonal finesse and flexibility to coordinate the different moving parts of the project as you articulate the strategic project vision, influence the team to embrace this vision and drive it to completion.
What Else You'll Bring to the Table
In addition to the qualifications detailed above, you'll need:
- Bachelor's degree in Health Information Administration or related discipline.
- Minimum 3-5 years of project management related responsibilities and professional DRG validation/ICD-9 coding experience; certification as a Coding Specialist preferred.
- Current in-patient coding experience.
- Knowledge of hospital systems, including grouper software, and environment with a demonstrated ability to analyze and evaluate medical information.
- Proven relationship building, problem solving and customer service skills.
- Excellent presentation and communication skills with the professional maturity to influence and interact with internal/external customers at various levels of the organization.
- Proficiency in a MS Office suite environment, including Word and Excel.
- Confidence and self-motivation paired with a team player mentality.
- Experience testifying in administrative or judicial proceedings is a plus.
What's in It for You
- Ground floor opportunity to make a discernible impact -- you'll get to shape this startup project and "make your mark" in short order as you ensure successful execution of project milestones/deliverables. We will also look to you to come in with a fresh set of eyes and identify opportunities for improvements in our systems/processes.
- Skills development -- our dynamic environment features learning in the forefront and you will gain exposure to a variety of enhanced recovery initiatives (if you don't already have that background) that will greatly strengthen your development as a project management professional.
- Autonomy and empowerment -- we'll entrust you with a degree of freedom and flexibility in achieving your goals, providing support when you need it and "elbow room" when you don't. Throughout HMS there are a number of home-based positions (as well as offices nationwide), and those with proven initiative and self-motivation enjoy multiple career choices.
- Career growth -- you'll join a company rich with opportunity: HMS is the undisputed industry leader in the coordination of program integrity services and benefits for government healthcare programs. On top of that, you'll become part of our Program Integrity division, a strategically important product line.
- A culture of growth and transition -- while we are growing strongly, we maintain the culture of a smaller company: employee input is welcome, and even new employees can make a visible impact in short order. Because of our growth we are looking for people with the initiative and resourcefulness to "take the ball and run with it." Excellence and innovation are highly valued.
- Excellent compensation -- in addition to a competitive wage, we offer a comprehensive benefits package that includes all you would expect plus a few pleasant surprises, such as a 401(k) plan with generous employer match, flexible spending plans, and much more.
More About Your Role
If you're a good fit for this position, you already know most of what the job entails. However, to be sure we're providing a complete picture, here are some details.
Reporting directly to the Service Line Manager, you will provide oversight to a Coding Specialist and a Project Specialist.
As you come on board, you will receive formal training at HFS on the nuances of their systems and database and you will in turn train the project team. Working from your home-based office, you will divide your Project Management activities between the field and visits to hospitals.
In general, your responsibilities include (but are not limited to):
- Overseeing all review operations for the Inpatient Hospital DRG Review contract.
- Collaborating with the Agency to schedule onsite reviews and determine the date and location of re-reviews.
- Collaborating with providers to ensure that medical records are available for onsite reviews and provided for any re-reviews completed offsite.
- Managing internal resources to ensure that review staff complete hospital reviews within the allotted timeframe.
- Performing periodic quality checks of data entered into the DRG database.
- Overseeing the creation and delivery of any reports or presentations requested by the client.
- Responding to questions from both the client and providers and meeting with providers and client as required.
- Hiring and training coding specialists and project specialists.
Keys to Success
To excel in this role you will develop a robust understanding of contract objectives and make it your mission to deliver to schedule and performance expectations. You will also maintain grace under pressure in a fast-paced, dynamic environment. Other facets of success include:
- Independent initiative -- you will bring exceptional organizational skills, resourcefulness and self-motivation along with the confidence and enthusiasm to follow through and obtain results.
- Excellent communication & interpersonal skills -- we're looking for a strong team player who can deliver on contract objectives, while building successful working relationships with HFS and the hospital providers.
- Flexibility -- change is the operative word here; you'll remain flexible in a highly dynamic environment and be able to "turn on a dime" when new priorities emerge.
- Innovation -- part of the proactive initiative we hope to see will come from your ability to dive into the Inpatient Hospital DRG Review Contract, gain a thorough understanding, and use creativity and innovation to develop solutions that provide added value and help us move forward as an organization.
If this sounds like the right mix of challenge and opportunity, and you meet the required qualifications, we look forward to hearing from you.
Who We Are
Health Management Systems has always been focused exclusively on the healthcare industry. In 1985, we began providing third party liability identification and recovery services to our first Medicaid agency client. Since then, we've partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars and save billions more through cost avoidance.
We take a proactive approach to growing our company, both organically and via mergers and acquisitions, to ensure we provide our clients with a broad offering of best-of-breed cost containment strategies to meet their financial and operational goals.
Opportunity Snapshot
This is a hands-on leadership opportunity to make a ground floor impact on an exciting new contract. Spearheading all aspects of the Inpatient Hospital DRG Review Contract with the Illinois Department of Healthcare and Family Services (HFS), you will navigate staff and resources through the entire project life-cycle as you expertly manage costs and deliverables. This will include everything from conducting a thorough needs assessment to figuring out the final deliverables to developing the timelines, conducting in-patient coding audits and collaborating closely with both HFS and the providers (up to 27 hospitals by end of 2010) to develop the processes and procedures to make this project happen.
To be a good fit for this opportunity you will have an RHIA certification along with three years of experience as a coder in the area of DRG validation and ICD-9 coding. Of course, as in any startup project involving multiple stakeholders, you will also have the interpersonal finesse and flexibility to coordinate the different moving parts of the project as you articulate the strategic project vision, influence the team to embrace this vision and drive it to completion.
What Else You'll Bring to the Table
In addition to the qualifications detailed above, you'll need:
- Bachelor's degree in Health Information Administration or related discipline.
- Minimum 3-5 years of project management related responsibilities and professional DRG validation/ICD-9 coding experience; certification as a Coding Specialist preferred.
- Current in-patient coding experience.
- Knowledge of hospital systems, including grouper software, and environment with a demonstrated ability to analyze and evaluate medical information.
- Proven relationship building, problem solving and customer service skills.
- Excellent presentation and communication skills with the professional maturity to influence and interact with internal/external customers at various levels of the organization.
- Proficiency in a MS Office suite environment, including Word and Excel.
- Confidence and self-motivation paired with a team player mentality.
- Experience testifying in administrative or judicial proceedings is a plus.
What's in It for You
- Ground floor opportunity to make a discernible impact -- you'll get to shape this startup project and "make your mark" in short order as you ensure successful execution of project milestones/deliverables. We will also look to you to come in with a fresh set of eyes and identify opportunities for improvements in our systems/processes.
- Skills development -- our dynamic environment features learning in the forefront and you will gain exposure to a variety of enhanced recovery initiatives (if you don't already have that background) that will greatly strengthen your development as a project management professional.
- Autonomy and empowerment -- we'll entrust you with a degree of freedom and flexibility in achieving your goals, providing support when you need it and "elbow room" when you don't. Throughout HMS there are a number of home-based positions (as well as offices nationwide), and those with proven initiative and self-motivation enjoy multiple career choices.
- Career growth -- you'll join a company rich with opportunity: HMS is the undisputed industry leader in the coordination of program integrity services and benefits for government healthcare programs. On top of that, you'll become part of our Program Integrity division, a strategically important product line.
- A culture of growth and transition -- while we are growing strongly, we maintain the culture of a smaller company: employee input is welcome, and even new employees can make a visible impact in short order. Because of our growth we are looking for people with the initiative and resourcefulness to "take the ball and run with it." Excellence and innovation are highly valued.
- Excellent compensation -- in addition to a competitive wage, we offer a comprehensive benefits package that includes all you would expect plus a few pleasant surprises, such as a 401(k) plan with generous employer match, flexible spending plans, and much more.
More About Your Role
If you're a good fit for this position, you already know most of what the job entails. However, to be sure we're providing a complete picture, here are some details.
Reporting directly to the Service Line Manager, you will provide oversight to a Coding Specialist and a Project Specialist.
As you come on board, you will receive formal training at HFS on the nuances of their systems and database and you will in turn train the project team. Working from your home-based office, you will divide your Project Management activities between the field and visits to hospitals.
In general, your responsibilities include (but are not limited to):
- Overseeing all review operations for the Inpatient Hospital DRG Review contract.
- Collaborating with the Agency to schedule onsite reviews and determine the date and location of re-reviews.
- Collaborating with providers to ensure that medical records are available for onsite reviews and provided for any re-reviews completed offsite.
- Managing internal resources to ensure that review staff complete hospital reviews within the allotted timeframe.
- Performing periodic quality checks of data entered into the DRG database.
- Overseeing the creation and delivery of any reports or presentations requested by the client.
- Responding to questions from both the client and providers and meeting with providers and client as required.
- Hiring and training coding specialists and project specialists.
Keys to Success
To excel in this role you will develop a robust understanding of contract objectives and make it your mission to deliver to schedule and performance expectations. You will also maintain grace under pressure in a fast-paced, dynamic environment. Other facets of success include:
- Independent initiative -- you will bring exceptional organizational skills, resourcefulness and self-motivation along with the confidence and enthusiasm to follow through and obtain results.
- Excellent communication & interpersonal skills -- we're looking for a strong team player who can deliver on contract objectives, while building successful working relationships with HFS and the hospital providers.
- Flexibility -- change is the operative word here; you'll remain flexible in a highly dynamic environment and be able to "turn on a dime" when new priorities emerge.
- Innovation -- part of the proactive initiative we hope to see will come from your ability to dive into the Inpatient Hospital DRG Review Contract, gain a thorough understanding, and use creativity and innovation to develop solutions that provide added value and help us move forward as an organization.
If this sounds like the right mix of challenge and opportunity, and you meet the required qualifications, we look forward to hearing from you.
Who We Are
Health Management Systems has always been focused exclusively on the healthcare industry. In 1985, we began providing third party liability identification and recovery services to our first Medicaid agency client. Since then, we've partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars and save billions more through cost avoidance.
We take a proactive approach to growing our company, both organically and via mergers and acquisitions, to ensure we provide our clients with a broad offering of best-of-breed cost containment strategies to meet their financial and operational goals.
