Associate Director - Medical Coding (Hyderabad)

Optum is a global organization that delivers care aided by technology to help millions of people live healthier lives The work you do with our team will directly improve health outcomes by connecting people with the care pharmacy benefits data and resources they need to feel their best Here you will find a culture guided by inclusion talented peers comprehensive benefits and career development opportunities Come make an impact on the communities we serve as you help us advance health optimization on a global scale Join us to start Caring Connecting Growing together Primary Responsibilities Owns an end to end process Develops functional market level and or site strategy plans production and or organizational priorities Identifies and resolves technical operational and organizational problems outside own team Product service or process decisions are most likely to impact entire functions and or customer accounts internal or external Comply with the terms and conditions of the employment contract company policies and procedures and any and all directives such as but not limited to transfer and or re-assignment to different work locations change in teams and or work shifts policies in regards to flexibility of work benefits and or work environment alternative work arrangements and other decisions that may arise due to the changing business environment The Company may adopt vary or rescind these policies and directives in its absolute discretion and without any limitation implied or otherwise on its ability to do so Functional Competencies GOM Plan Implement Manage Operations Programs and Strategies Utilize standard project plan templates to create and or tailor project plans to specific customers needs Analyze RFP contract language and incorporate requirements into project plans Assist internal and or external business partners with completion of tasks and resolution of issues and problems with program implementation Establish and or implement internal and or external service level agreements in order to ensure ability to monitor and measure program performance e g turnaround time quality effectiveness Identify and or secure resources e g funding staffing system security real estate and or telecommuting requirements hardware software required to implement programs Review create and or maintain workflows to ensure they are up-to-date and operationally productive Provide guidance expertise and or assistance to internal and or external partners e g claims call center benefits clinical to ensure programs and strategies are implemented and maintained effectively Communicate with and help internal and or external partners interpret contractual requirements in order to ensure effective problem solution and strategy implementation Provide input to internal and or external stakeholders e g sales shared business partners pre-service vendors facilities in order to drive effective business plan and sales strategy development GOM Monitor Evaluate Operations Program and Strategy Performance Seek feedback from customers to determine success of overall project management and implementation Monitor project performance against internal and or external service level agreements Work with internal and or external partners e g claims call center to ensure accurate reports are produced to validate program performance review Ensure performance is tracked accurately utilizing internal tools and processes e g dashboards scorecards reports Request and or receive relevant performance data from internal partners and review for accuracy Manipulate provided data into applicable tools and reports in order to facilitate performance review and analysis Review consolidated operational performance reports in order to determine overall effectiveness make necessary changes and identify opportunities for new programs or program consolidation or expansion Incorporate operations program performance information into strategic and business planning Delegate post-implementation tasks to appropriate stakeholders to fulfill RFP contractual agreements Analyze operational performance on relevant criteria e g targeted financial metrics quality indicators performance guarantees and or incentives GOM Build Maintain Manage Relationships with Operations Stakeholders Build and demonstrate an understanding of relevant business areas leadership structure responsibilities and work flow Provide standard performance reports e g scorecards to update relevant internal and or external stakeholders on the status of work projects Conduct regular meetings e g JOCs QBRs with relevant internal and or external stakeholders to review and discuss updates and outstanding issues e g project implementation readiness compliance and or quality audit results out-of-compliance issues staffing issues Develop corrective action plans to address and or resolve relevant internal and or external stakeholders concerns or issues regarding operational issues Conduct deep dive program reviews with relevant internal and or external stakeholders to identify opportunities for continuous improvement Ensure relevant internal and or external stakeholders e g vendors providers leased network are provided with correct and or updated processes programs and or policies e g fee schedules Partner with relevant internal and or external stakeholders to develop and or review potential operational strategies programs and plans e g affordability initiatives quality programs projected resource needs GOM Support Develop Ensure Compliance with Operations Policies Procedures and Regulation Demonstrate understanding of and adhere to relevant policies procedures and regulations Stay abreast of changes and or updates in relevant policies procedures and regulations Train and educate internal stakeholders on relevant policies and procedures Communicate and coordinate with and or help internal and or external partners interpret contractual requirements in order to ensure compliance with contractual and regulatory stipulations Provide input into develop and or modify policies and procedures Ensure staff utilize relevant websites required in order to obtain up-to-date policies guidelines procedures and regulations Track attendance on training for required policies procedures and regulations Monitor and or report on-going compliance and related outcomes e g claim denials complaints clinical metrics to relevant internal and or external stakeholders e g regulatory agencies customers vendors GOM Review Manage Drive Operations Efficiency Quality and Financial Performance Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance e g encourage participation in Six Sigma projects Ensure internal partners and or external vendors adhere to business and contractual agreements Conduct end-to-end testing of applicable processes tools procedures and systems platforms to validate adherence to RFP contract requirements Ensure that business continuity emergency response plans are reviewed and tested regularly up-to-date and can be readily executed Utilize relevant systems and tools to identify and or test opportunities for efficiency improvements e g parallel variable testing Demonstrate understanding of budgeting and forecasting tools terminology and processes Analyze budget performance and variances throughout the fiscal year and recommend and or make necessary adjustments and corrections Work with relevant internal partners e g Finance Underwriting to identify resource requirements and or create budgets and forecasts Review and assign projects initiatives based on resource capacity capability and expertise Values Based Competencies Integrity Value Model and Ensure Ethical Behavior Comply with Applicable Laws Regulations and Policies Demonstrate Integrity Require Integrity and Ethical Behavior from Others Compassion Value Deliver Value to Customers Maximize Customer Growth and Retention Optimize the Customer Experience Relationships Value Lead and Develop People Bring in the Right Talent Develop People Drive Employee Engagement Foster Teamwork and Collaboration Learn and Develop Self Leverage Diversity and Inclusion Relationships Value Communicate Effectively Communicate with Impact Influence and Negotiate Listen Actively Present Effectively Innovation Value Lead Change and Innovation Demonstrate Emotional Resilience Implement Cutting-edge Solutions Manage Change Performance Value Drive Sound Disciplined Decisions Apply Financial Knowledge Make Decisions to Drive Action Performance Value Drive High-Quality Execution Communicate Clear Direction Drive Operational Excellence Manage Execution Required Qualifications Undergraduate degree from an accredited college university Medical coding Certified with AAPC or AHIMA 14 years of people management experience 13 years of solid Medical coding background Experience handling Business Pertaining to Risk adjustment coding or Provider coding Experience in Handling and Managing the P L for any of the business units Project Management experience Handled 350 FTE as team size At UnitedHealth Group our mission is to help people live healthier lives and make the health system work better for everyone We believe everyone-of every race gender sexuality age location and income-deserves the opportunity to live their healthiest life Today however there are still far too many barriers to good health which are disproportionately experienced by people of color historically marginalized groups and those with lower incomes We are committed to mitigating our impact on the workplace and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission Apply on Kit Job: kitjob.in/job/4mcgvb