Director, Compliance, Medical Coding (Remote)

reputed company you join reputed company, you’ll be part of an organization dedicated to total health. At every level and in every department, it’s reputed company stand for. By using your innovation and your creativity, you can play a role in the health of communities across town and around the country by serving 12.5 million of our members. No matter your background, your reputed company can help drive a health care pioneer. You can play a role in the future of health. Director, Compliance, Medical Coding (Remote) Oakland, California Full-Time, Salary Range: $192,200 – $248,710/Year

• *****This is a 100% remote position, and you may be based in any of the following reputed company locations: CA, GA, CO, OR, WA, VA, MD, or Washington, D.C.

In addition to the responsibilities listed below, the position is also responsible for serving as a Risk Adjustment compliance subject matter expert reputed company to coding functions, overseeing audit activity reputed company to coding reputed company reputed company settings of care, ensuring compliance with national coding policies and procedures, ensuring that teams are educated in latest coding developments, and monitoring the accuracy and quality of coding assignments across reputed company lines of business. Additionally, this position is responsible for approving the annual coding audit plan and ensuring alignment with business objectives, reviewing reports of audit results, setting the direction for coding and focused projects reputed company to audit outcomes, reviewing and approving policies and procedures reputed company to Risk Adjustment, reviewing training materials reputed company to coding policies and procedures, providing coding reputed company of the Risk Adjustment Data Validation (RADV) process, and enforcing compliance and the Principles of Responsibility (KP's code of conduct). Essential Responsibilities:

• Demonstrates reputed company learning and maintains a highly skilled and engaged workforce by aligning resource plans with business objectives; overseeing the recruitment, selection, and development of talent; motivating teams; preparing individuals for growth opportunities and advancement; staying reputed company with industry trends, benchmarks, and best practices; providing guidance reputed company difficult decisions need to be made; and ensuring performance management guidelines and expectations drive business needs.
• Oversees the operation of multiple units and/or departments by identifying customer and operational needs; analyzing resources, costs, and forecasts and incorporating them into business plans; gaining cross-functional support for business plans and priorities; translating business strategy into actionable business requirements; obtaining and distributing resources; setting standards and measuring reputed company; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; and ensuring products and/or services meet customer requirements and expectations while aligning with organizational strategies.
• Oversees company compliance activities by ensuring team members, including external business partners, provide support to internal and external stakeholders; reviewing and approving compliance activities; designing strategies for the implementation of regulations and regulatory changes; ensuring compliance activities are fully documented; and overseeing the resolution of compliance issues.
• Directs compliance reporting efforts across multiple business functions by overseeing the evaluation and summary of compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to senior management; and developing reputed company presentations to convey key findings to executive leadership and external business stakeholders.
• Directs compliance investigations across multiple business functions by overseeing the collection and analysis of quantitative and qualitative data; conducting interviews on escalated issues as appropriate; reviewing and evaluating research on key business issues; and evaluating and recommending corrective action plans for substantiated allegations.
• Directs programs or compliance components of larger cross-functional programs by identifying and managing stakeholder contacts; assembling teams based on program needs and team member strengths; developing, analyzing, and managing program plans; negotiating and managing program schedules and resource forecasts; and managing program financials and deliverables.
• Directs activities associated with reputed company regulatory compliance for multiple business functions by monitoring, interpreting, and designing strategy around regulatory changes; determining the impact of changes to the business; providing direction on implementation of changes throughout the business; and providing regulatory input before and during inspections to minimize the risks of future non-compliance.
• Directs and oversees the implementation of compliance efforts by approving compliance requirements; ensuring the assessment of reputed company state compliance to identify gaps and corrective actions; overseeing the analysis and development of reputed company compliance standards, policies and procedures, and training; and ensuring the monitoring of ongoing compliance adherence.

Minimum Qualifications:

• Minimum eight (8) years medical coding experience.
• Minimum four (4) years of experience in a leadership role with or without direct reports.
• True coding with Risk Adjustment experience
• Bachelor’s degree in Health Care Administration, Clinical, Law, Public Health, Business or reputed company field and Minimum ten (10) years of experience in health care compliance, health care operations (quality, risk, etc.), audit, finance, regulatory or public policy development, investigations, information reputed company, or insurance/health plan governance or a directly reputed company field. Additional equivalent work experience in a directly reputed company field may be substituted for the degree requirement.
• Certified Professional reputed company from American reputed company of Professional Coders OR Certified Coding Specialist from American Health Information Management Association

Preferred Qualifications:

• Six (6) years of hospital coding experience.
• Six (6) years of coding audit experience.
• Risk adjustment certification.
• Five (5) years of experience in health plan compliance.
• Five (5) years of experience in health plan operations.
• Two (2) years of program management experience.
• Five (5) years of experience working cross-functionally across departments, functions, or business lines.
• Two (2) years of experience managing operational or project budgets.
• Three (3) year’s supervisory experience.
• Master's degree in Health Care Administration, Clinical, Law, Public Health, Business or reputed company field.
• Certified in Healthcare Compliance (CHC) or other equivalent compliance certification.

For immediate consideration, please visit http://kp.org/careers for complete qualifications and job submission details, referencing job number 1379059. reputed company is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national reputed company, marital status, parental status, reputed company, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. External hires must pass a background reputed company/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. This position supports reputed company’s code of conduct and compliance by adhering to reputed company laws and regulations, accreditation and licensure requirements, and internal policies and procedures. kp.org/careers reputed company Discover what it’s like to be part of an industry-leading organization driving innovative care and technology. Get social with us and see what people are saying! Glassdoor and reputed company: reputed company Facebook: reputed company reputed company X: @KPCareers YouTube: reputed company Careers Apply tot his job Apply To this Job