Director QA - RCM

May 7, 2024
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Job Title: Director QA - RCM

Report To: Senior Vice President

Experience: 15 - 25 Years

Qualification: Any Degree

Location: Bangalore / Coimbatore

Shift Time: 12:00 PM - 09:00 PM (Mid Shift)

Mode: Work from office

Terms-Fulltime/Part time/Contractual: Full-time

Job Summary

To be a successful QA Director, you must have excellent critical thinking skills to create compelling business cases, influence stakeholders, and demonstrate technical and industry knowledge. You should be a valuable team member with initiative, flexibility, and a strong orientation toward team goals in a rapidly changing environment. Additionally, you should be able to prioritize effectively, handle multiple projects simultaneously, and guide quality teams with tactical decision-making to ensure that accounts receivable interventions meet the industry's best standards.

Key Responsibilities

  • Quality Management Strategy:
    1. Develop and implement a comprehensive quality management strategy aligned with organizational goals, industry best practices, and regulatory requirements specific to the RCM US healthcare industry.
  • Quality Assurance Processes:
    1. Oversee developing, implementing, and maintaining effective quality assurance processes and procedures across all relevant departments, ensuring compliance with industry standards, regulations, and customer requirements.
  • Compliance and Regulatory Oversight:
    1. Stay abreast of relevant laws, regulations, and accreditation requirements applicable to the RCM US healthcare industry. Ensure adherence to these standards, implement necessary compliance initiatives, and conduct regular audits to monitor compliance levels.
  • Performance Metrics and Reporting:
    1. Define and establish key performance indicators (KPIs) and quality metrics to assess and monitor the effectiveness of quality management processes. Generate regular reports, analyze data, and present findings to executive management, highlighting areas for improvement and action plans.
  • Continuous Improvement Initiatives:
    1. Lead and facilitate continuous improvement initiatives to drive operational excellence, enhance quality outcomes, and optimize efficiency within the organization. Foster a culture of continuous improvement, encourage employee engagement, and support implementing Lean or Six Sigma methodologies where applicable.
  • Staff Training and Development:
    1. Collaborate with Human Resources to develop and deliver training programs related to quality management, regulatory compliance, and industry standards. Provide guidance and support to staff members, ensuring they have the necessary knowledge and skills to meet quality objectives.
  • Stakeholder Engagement:
    1. Act as a primary point of contact for quality-related inquiries, concerns, and communications from internal stakeholders, clients, auditors, and regulatory agencies. Build and maintain effective relationships, addressing quality-related issues promptly and effectively.
  • Risk Assessment and Mitigation:
    1. Identify potential risks and vulnerabilities related to quality management and develop strategies to mitigate them. Conduct risk assessments, implement risk management plans, and ensure the organization is prepared to respond to quality-related incidents or emergencies

Mandatory Skills

  • Bachelor's degree in Any field, Business, or a related field.   Master's degree preferred.
  • Proven experience (minimum 15-25 years) in quality management, preferably in the RCM sector of the US healthcare industry.
  • Strong knowledge of healthcare industry regulations, accreditation standards, and compliance requirements.
  • Demonstrated experience in developing and implementing quality management strategies, policies, and procedures.
  • Excellent understanding of quality assurance processes, performance metrics, and continuous improvement methodologies (e.g., Lean, Six Sigma,   PDCA).
  • Strong leadership skills with the ability to influence and engage stakeholders at all levels of the organization.
  • Exceptional analytical, problem-solving, and decision-making abilities.
  • Excellent communication and presentation skills, with the ability to effectively convey complex information to diverse audiences.

Desired skills

  • Should be flexible to extend
  • Hands on experience in medical billing softwares like Nextgen, Epic, and Athena would be an added advantage

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