Sutter Health Clinical Quality Coding Director in Sacramento, California
Under general direction from the Vice President, Quality & Clinical Effectiveness, the Clinical Quality Coding Director will provide strategic administration, coordination, and maintenance of all operational activities and reporting, including the development and implementation of programs and processes to address issues required for the successful operation of Hierarchical Condition Category (HCC) / Clinical Quality Coding risk adjustment and reporting measures. The Director will oversee a staff of Clinical Quality Coding professionals in support of the Comprehensive Health Assessment program. The Director must possess superior interpersonal qualities with an ability to articulate a vision and influence others in the support of program objectives and accomplishment of strategic goals. Excellent communication, facilitation and conflict resolution skills, within a positive and engaging work environment are essential.
Bachelor’s Degree, Healthcare Administration or other area of study required
Master’s Degree Healthcare Administration or other area of study preferred
Licensures and Certifications
RHIA and/or RHIT preferred
Certified Professional Coder (CPC) and/or Certifified Coding Specialist (CCS) required
Certified Risk Adjustment Coder (CRC) Within 1 year required
5-7+ years of professional coding experience including coding abstraction, and advanced knowledge of coding rules within the risk adjustment forum required.
3+ years of Risk Adjustment Data Validation (RADV) process and/or audit experience required.
3-5+ years hands on knowledge of Medicare, Commercially Adjusted Risk Plans. Knowledge and experience in risk adjustment rules and regulations required.
7+ years experience in Project Management leading projects teams, specifically in the revenue cycle arena required.
5-7+ years of staff management and executive experience required.
Proficient use of grouper software and/or coding reference books to assign/validate diagnosis codes required.
Knowledge of APC and DRG assignment logic, National Correct Coding Initiative edits, Coding Clinic and CPT Assignment coding guidelines and the contents of a medical record required.
Demonstrated excellent verbal and written communication skills.
Primary Location: California, Greater Sacramento Area, Sacramento
Organization: Sutter Health System Office
Employee Status: Regular
Position Status: Exempt
Job Shift: Day
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Monday-Friday
Weekend Requirements: None
Schedule: Full Time
Hrs Per 2wk Pay Period: 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.