Program Manager

About the role

Koniag Advisory Business Solutions LLC, a Koniag Government Services company, is seeking a Program Manager to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust.

Responsibilities

• Lead the overall execution of the IHS coding and billing contract for both Northern and Southern Tiers.
• Serve as the primary point of contact for Government customers, including Northern Tier and Southern Tier leadership.
• Ensure the contract meets programmatic goals related to backlog reduction, coding throughput, billing throughput, timeliness, compliance, and collections.
• Develop and maintain the master program plan, staffing plan, workflow plan, and performance monitoring approach.
• Coordinate and monitor schedule, staffing, pricing inputs, and technical performance across all contract functions.
• Identify performance risks, operational bottlenecks, and staffing gaps, and implement corrective actions promptly.
• Lead internal status reviews and customer meetings and provide clear updates on progress, challenges, and mitigation actions.
• Support contract administration activities, including proposals, contract modifications, staffing changes, preparing monthly reporting deliverables, assist with internal accounting and operational planning as needed.
• Ensure all work is performed in accordance with contract requirements, applicable law, IHS policy, privacy standards, and company procedures.
• Direct and supervise all staff assigned to the contract.
• Oversee day-to-day operations of both the coding and billing teams to ensure efficient workflows and balanced workloads.
• Maintain productivity against program expectations, including coder throughput and biller throughput.
• Ensure staff are focused on high-value work, including Medicare and Medicaid all-inclusive visit opportunities and other reimbursement-sensitive encounters.
• Coordinate onboarding, training, telework approval recommendations, leave coverage, and staffing continuity.
• Conduct interviews, participate in candidate selection, and lead onboarding for new hires.
• Partner with team supervisors to establish priorities, quality controls, escalation pathways, and standard operating procedures.
• Ensure hospitals and clinics receive responsive support and that operational issues are addressed quickly and professionally.
• Meet regularly with hospitals, clinics, Government representatives, and internal leadership to review program performance and operational needs.
• Support issue resolution involving documentation, coding, billing, denials, workflow barriers, and backlog prioritization.
• Communicate recurring trends, root causes, and recommended process improvements to Government and contractor leadership.
• Support strategic planning for possible expansion into larger billing teams and separate North and South coding teams.
• Establish and monitor performance metrics for coding accuracy, billing timeliness, denial trends, backlog reduction, productivity, and quality.
• Ensure supervisors and leads are conducting appropriate quality checks, audits, reporting, and corrective action follow-up.
• Monitor the program for compliance with billing, coding, documentation, privacy, and security requirements.
• Promote continuous improvement in workflow design, staff utilization, and output quality.
• Ensure all deliverables, reports, and customer responses are timely, accurate, and professionally prepared.

Requirements

• Bachelor's degree in Healthcare Administration, Health Information Management, Business Administration, Public Health, Nursing, or a related field; equivalent relevant experience may be considered.
• Seven or more years of progressive experience in healthcare program management, operations management, health information management, revenue cycle, medical coding, medical billing, or closely related healthcare contract operations.
• Three or more years of supervisory or management experience leading multi-person teams.
• Demonstrated experience managing healthcare operations involving coding, billing, claims, reimbursement, denials, revenue cycle, or medical records functions.
• Experience managing program schedules, staffing, workflow performance, and customer-facing operations.
• Strong written and verbal communication skills, including experience briefing leadership and clients.
• Strong organizational, analytical, and problem-solving skills.
• Able to manage competing priorities in a deadline-driven, high-volume environment.

Qualifications

• Must be able to obtain and maintain a favorable Tier II background investigation determination as required by IHS.
• Must successfully complete all required credentialing, fingerprinting, identity proofing, badge, and access requirements.
• Must comply with all IHS, HHS, facility, and company requirements related to privacy, confidentiality, records management, and cybersecurity.
• Must protect PHI and other sensitive information in paper and electronic form.
• Must complete required HIPAA, privacy, and IT security training and maintain compliance thereafter.
• Must immediately report suspected privacy breaches, security incidents, improper disclosures, lost devices, malware events, or unauthorized access.

Skills

• Knowledge of Medicare and Medicaid all-inclusive visit billing, outpatient and inpatient reimbursement, and alternate resources billing.
• Knowledge of medical coding and billing standards, including ICD-10, CPT, HCPCS, UB-04, CMS-1500, and payer requirements.
• Experience reducing operational backlogs and standing up performance-driven workflows.
• PMP, RHIA, RHIT, CCS, CPC, CMRS, or similar credential preferred.
• Experience in federal contracting or managing healthcare services under a Government contract.

Benefits

We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending accounts, paid holidays, three weeks paid time off, and more.

Pay

Competitive compensation.

Schedule

Regular on-site presence expected, especially during startup, onboarding, customer meetings, staff supervision, and performance management activities. Work hours may flex based on operational and customer requirements. Travel to supported hospitals, clinics, or customer meetings will be required.