DRG Senior Manager

Responsibilities

• Ensures client savings and internal revenue goals are achieved
• Ensures a pipeline of selected cases are placed in the workflows each month
• Ensures records are requested in a timely manner each month for all clients and a good process exists for daily receipt of records
• Ensures daily productivity goals are achieved and tracks if audited claims will result in savings/revenue
• Ensures revenue/findings files are submitted each month in a timely manner and a returning file is received for invoicing
• Ensures invoicing is performed timely each month
• Ensures record fees and client confirmed overpayments are imported into audit system for tracking future forecasting and reporting
• Understands factors that generate/prevent revenue and solves issues that puts savings/revenue at risk

Performance Management

• Ensures employees are aware, connected and accountable to program goals
• Ensures productivity and quality goals are established and communicated to all employees
• Ensures employees are provided with monthly one on ones (PIP/Counseling when below standard)
• Ensures team meetings are held to communicate with staff (performance, issues, risks, updates, plans)
• Provides training (re-training) coaching and development to ensure employees can be successful in their role
• Builds a high performance team and strives for operational excellence

Client Management

• Provides client with performance updates as needed and/or when scheduled
• Sets up and manages team to be responsive to client emails/requests and provides quality, satisfactory responses
• Works with clinical staff/leaders to prepare for client presentations, address issues, and provide appropriate updates

Continuous Improvement

• Understands issues, barriers, performance gaps and creates action plans to improve results
• Works across functions to solve issues and improve results (Selections, Workflows, IT, Implementations)
• Lets others know about at least 1 new solution/improvement per quarter
• Affords assistance to others as needed

Qualifications

• Supervisory Responsibilities: Supervisors, clinical and non-clinical, coordinators
• Works hand in hand with Clinical Leaders
• Bachelor’s degree or equivalent work experience in clinical auditing
• Minimum 5-8 years or equivalent work experience in clinical auditing/supervisory
• Minimum 2 years of Healthcare experience
• CCS certification
• DRG experience
• Strong leadership skills and ability to perform a wide range of duties
• Excellent computer skills, proficient in excel, word, and outlook
• Excellent people management skills, interpersonal skills, and communication skills
• Able to train and delegate