Director of Health Information Management (HIM) - WA/CO

Reviews trends and broader needs to help create workflows, ensuring teams work adheres to legal, compliance, and reporting standards, approving recommendations based on feedback from team(s). Ensures finance are completed accurately, working with assigned budget, ensuring financial needs are met; reviews and recommends new systems used to take inquiries from providers, members, attorneys, and other stakeholders; directs project execution and identify business partnering with others to implement strategic and innovative process improvement efforts. Directs the analysis of data. Oversees teams quality and reviews and approves recommendations. Partners with stakeholders to develop long-term strategic plans for process improvement with cross-organization impact. Oversees training delivery by ensuring the training is well-received while also providing background when introducing new training; Builds and manages vendor relationships.

• Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.


• Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.


• Ensures the organizations work is in compliance by: reviewing trends, patterns, broader needs of the team to help create workflows and remediating while ensuring employees adhere to federal and state laws, and applicable compliance standards, and making process updates and training based on the monthly leadership quality reports.


• Ensures accurate patient accounts by: reviewing and recommending new systems used to take inquires from providers, members, attorneys, and other insurance personnel to answer billing questions and evaluating new systems.


• Directs the denial process by: overseeing the organizations work of performance affecting denials and ensuring effective remediation using knowledge of industry regulations and taking the teams data analysis and drawing conclusions including risks when making recommendations while also ensuring the teams complete remediation activities, also identifying trends and patters and making recommendations at the system workflow level and driving partnerships throughout the organization.


• Ensures finances are completed accurately by: developing and securing budget for a assigned function budget, monitoring usage, reviewing and approving expenses, ensuring proper use of expenditures, and negotiating vendor prices.


• Oversees performance management initiatives by: reviewing managers performance and developing advanced strategies to create metrics associated with the organizations performance and exercising tact and sensitivity in coaching to deliver performance improvement and contributing to the creation and implementation of information management, reporting, and analytical strategies and analytical tools. uses expert knowledge to bring together the organizations information to ensure quality of vendor performance and make decisions and developing advanced complex strategies to monitor vendor performance and remove barriers to implementation of collections, coding services, systems, coverage validation, income verification and approve vendor invoices.


• Oversees process management initiatives by: using expert knowledge in several professional fields and critical information from several diverse areas to oversee the process, create strategies, plan, recommend, implement, and approve process improvements, and identify business needs with operations managers, IT, clinicians, health plan managers, and vendors while also guiding organization-wide solutions to translate business needs into project requirements that are then used to develop project specifications and action plans to drive strategic projects.


• Oversees project management initiatives by: directs project execution and management efforts by directing team members to collaborate with stakeholders across functions and organizations to ensure the project is successfully executed and project-based changes are implemented.


• Leads regulatory reporting by: researching, devising, and overseeing the incorporation of regulation standards into overall reporting processes and overseeing regulatory extracts while also overseeing required changed by organizing resources and driving change.


• Oversees with vendor relationships by: building and managing relationship with vendors by working with internal senior management to manage execution of work in accordance with organizational guidelines while also seeking and using expert knowledge to develop complex regional procedures, guidelines, strategies, and methods for managing vendor relationships.


• Oversees systems management initiatives by: partnering with systems teams to ensure that functionality aligns with operational need, approves recommended updates, and oversee operational implementation of new systems and system functionality and assess the outcomes and make recommendations.


• Oversees training delivery by: developing advanced strategies to develop quality education on and implementing measures to ensure the training is well-received while also providing background when introducing new training.


• Oversees the training development process by: using expert knowledge in several professional fields and critical, complex information from several diverse areas to identify education and training requirements that reflect revenue cycle changes to develop strategic training content and providing approval.