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Manager, Compliance - Clinical Documentation Coding & Auditing Services

Kaiser Permanente
  • Pasadena, CA
    4 days ago

    Job Description

    Overview: The Manager is responsible for overseeing our Quality Assurance Team of CPC/CCS certified Compliance Auditors to ensure accurate, compliant documentation and coding practices in alignment with regulatory requirements, organizational policies, and industry standards. This role manages the execution of medical record documentation quality assurance audits, monitors audit quality and consistency, and provides guidance and coaching to support auditor development and performance. The position manages day-to-day quality assurance audit operations, including assigning work, reviewing audit findings, and ensuring timely and accurate reporting. The Manager evaluates audit results, identifies trends, risks, and opportunities for improvement to support provider and auditor education and continuous improvement efforts.

    Job Summary:

    This manager level position is primarily responsible for managing company compliance activities in partnership with internal and external stakeholders and managing strategic compliance initiatives. Responsibilities include managing compliance reporting efforts, compliance investigation, and activities associated with continued regulatory compliance across one or more business functions. Additional key responsibilities include managing the implementation of compliance efforts through monitoring, interpreting, and designing strategy around regulatory changes. This managing level employee also manages projects or compliance components of larger cross-functional projects including identifying and managing stakeholders.

    Essential Responsibilities:

    • Pursues professional growth and provides developmental opportunities for others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; training and developing talent for growth opportunities; delegating tasks and decisions; fostering open dialogue amongst team members; executing performance management guidelines and expectations; and working closely with employees to set goals and provide open feedback and coaching to drive performance improvement.
    • Manages designated work unit by translating business plans into tactical action items; ensuring all policies and procedures are followed; delegating tasks to meet goals and objectives; overseeing the completion of work assignments; aligning team efforts; building accountability for and measuring progress in achieving results; identifying and addressing improvement opportunities; removing obstacles that impact performance; and guiding performance and developing contingency plans accordingly.
    • Manages company compliance activities by partnering with internal and external stakeholders; applying established regulations and standards to compliance efforts; managing the design, development, and execution of strategic compliance initiatives; overseeing the analysis of regulations and regulatory changes, and their application to operations; and overseeing the documentation of compliance activities.
    • Manages compliance reporting efforts across one or more business functions by managing the evaluation and summary of compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to senior management; and developing complex presentations to convey key findings to leadership and external business stakeholders.
    • Manages compliance investigations across one or more business functions by managing the collection and analysis of quantitative and qualitative data; leading interviews as appropriate; researching key business issues; and evaluating and recommending corrective action plans for substantiated allegations.
    • Manages projects or compliance components of larger cross-functional projects by identifying and managing stakeholder contacts; assembling teams based on project needs and team member strengths; developing, analyzing, and managing project plans; negotiating and managing project schedules and resource forecasts; and managing project financials and deliverables.
    • Manages activities associated with continued regulatory compliance for one or more business functions by monitoring, interpreting, and designing strategy around regulatory changes; determining the impact of changes to the business; providing direction on implementation of changes throughout the organization; and providing regulatory input before and during inspections to minimize the risks of future non-compliance.
    • Manages the implementation of compliance efforts by approving compliance requirements; ensuring the assessment of current state compliance to identify gaps and corrective actions; managing the analysis and development of complex compliance standards, policies and procedures, and training; and ensuring and monitoring ongoing compliance adherence.

    Numbers & Facts

    LocationPasadena, CA
    IndustryHealthcare Services
    Company Size10,000 employees or more
    Year Founded1945
    Websitehttp://www.kp.org/careers

    About Company

    At Kaiser Permanente, we are relentless in our pursuit of excellence. Driven by our mission to provide the highest quality preventive medicine, we are committed to eliminating health care disparities, and to making lives better through innovation, technology, and research. Our desire to deliver the best possible care inspires us to promote wellness among our members, communities, and each other. It also fuels our belief that everyone — regardless of circumstance — deserves access to affordable care, which further drives our motivation to expand our reach. Founded nearly 80 years ago, our unique business model sets us apart — positioning us to drive improvements across the industry and around the world.

    Skills

    • Analysis Skillsunmatched
    • Auditingunmatched
    • Business Planunmatched
    • Certified Coding Specialist (CCS)unmatched
    • Certified Professional Coder (CPC)unmatched
    • Clinical Study Publicationsunmatched
    • Coachingunmatched
    • Contact Managementunmatched
    • Contingency Plansunmatched
    • Continuous Improvementunmatched
    • Corporate Complianceunmatched
    • Corrective Actionunmatched
    • Cross-Functionalunmatched
    • Documentationunmatched
    • Financial Managementunmatched
    • Financial Projectionsunmatched
    • Forecastingunmatched
    • Industry Standardsunmatched
    • Insurance Documentationunmatched
    • Leadershipunmatched
    • Maintain Complianceunmatched
    • Medical Codingunmatched
    • Medical Recordsunmatched
    • Negotiation Skillsunmatched
    • Operational Auditunmatched
    • People Managementunmatched
    • Performance Managementunmatched
    • Process Improvementunmatched
    • Project Evaluationunmatched
    • Project Planningunmatched
    • Project Scheduleunmatched
    • Project/Program Managementunmatched
    • Qualitative Analysisunmatched
    • Quality Assuranceunmatched
    • Quality Managementunmatched
    • Quality Monitoringunmatched
    • Quantitative Analysisunmatched
    • Regulationsunmatched
    • Regulatory Complianceunmatched
    • Regulatory Requirementsunmatched
    • Risk Analysisunmatched
    • Risk Managementunmatched
    • Schedule Developmentunmatched
    • Set Goalsunmatched
    • Standards Developmentunmatched
    • Strategic Planningunmatched
    • Talent Managementunmatched
    • Team Playerunmatched
    • Time Managementunmatched
    • Trend Analysisunmatched

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