Director - Quality & Training
ECLAT Health Solutions
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Zusammenfassung
ECLAT Health Solutions seeks a Director of Quality & Training to lead Quality Assurance, Training, Process Excellence, and Capability Development across US Healthcare RCM operations. You will drive quality transformation, workforce capability, compliance governance, and client satisfaction at scale.
The role requires deep expertise in US healthcare processes, quality frameworks, training methodologies, and large-scale people leadership, overseeing multiple RCM service lines and client
Qualifikationen
- Bachelor's Degree in a related field.
- MBA preferred for leadership roles.
- 15+ years of experience in US Healthcare and Revenue Cycle Management.
Aufgaben
- Develop and execute enterprise-wide Quality and Training strategies.
- Establish governance for quality assurance and workforce development.
- Lead Lean Six Sigma and Quality Excellence initiatives.
Kenntnisse
Ausbildung
Tools
Jobbeschreibung
The Director - Quality & Training is responsible for leading the organization's Quality Assurance, Training, Process Excellence, and Capability Development functions across US Healthcare Revenue Cycle Management (RCM) operations. This role drives quality transformation, workforce capability enhancement, compliance governance, client satisfaction, and continuous improvement initiatives while ensuring alignment with organizational and client objectives.
The incumbent will provide strategic leadership across multiple RCM service lines including Patient Access, Eligibility & Benefits Verification, Prior Authorization, Medical Coding, Charge Entry, Payment Posting, Accounts Receivable (AR) Follow-up, Denial Management, and Provider Credentialing.
The role requires deep expertise in US healthcare processes, quality frameworks, training methodologies, operational excellence, regulatory compliance, and large-scale people leadership.
- Develop and execute enterprise-wide Quality and Training strategies supporting business goals.
- Establish governance frameworks for quality assurance, process compliance, and workforce development.
- Drive operational excellence initiatives across all healthcare delivery functions.
- Partner with Operations, Clients, HR, and Business Excellence teams to achieve strategic objectives.
- Lead transformation programs focused on quality improvement, automation, and capability building.
- Define and implement quality standards, scorecards, and audit methodologies.
- Ensure consistency of audit practices across business units and clients.
- Lead internal quality reviews and client audits.
- Drive quality improvement initiatives to reduce errors, defects, and revenue leakage.
- Establish robust quality governance forums and leadership reviews.
- Medical Billing
- Charge Entry
- Payment Posting
- AR Follow-up
- Denial Management
- Prior Authorization
- Insurance Verification
- Patient Access Services
- Develop organizational learning and capability development strategy.
- Lead all training functions including:
- New Hire Training
- Process Training
- RCM Domain Training
- Compliance Training
- Leadership Development
- Refresher Programs
- Cross-skilling Initiatives
- Design competency frameworks and certification programs.
- Establish career progression and skill enhancement programs.
- Drive training effectiveness through measurable outcomes.
- Lead Lean Six Sigma and Quality Excellence initiatives.
- Establish Root Cause Analysis (RCA) and Corrective Action (CAPA) mechanisms.
- Standardize best practices across accounts and service lines.
- Identify opportunities for process simplification and automation.
- Drive continuous improvement projects resulting in revenue enhancement and cost optimization.
- Act as executive sponsor for Quality and Training engagements with clients.
- Present quality and performance insights during Monthly and Quarterly Business Reviews.
- Support client transitions, implementation programs, and process migrations.
- Manage client escalations related to quality, compliance, and training effectiveness.
- Build trusted partnerships with client leadership teams.
Ensure adherence to:
- HIPAA Regulations
- Internal Compliance Standards
- Client-Specific Regulatory Requirements
- Compliance governance reviews
- Audit readiness programs
- Risk identification and mitigation
- Regulatory change management
- Develop executive dashboards and performance scorecards.
- Track leading and lagging quality indicators.
- Analyse trends, defect patterns, audit findings, and training effectiveness.
- Present actionable insights to senior leadership and clients.
- Utilize data analytics to drive decision-making and process improvements.
- Lead Quality Managers, Training Managers, Process Excellence Leaders, and Capability Teams.
- Build a high-performance culture focused on accountability and continuous improvement.
- Drive succession planning and leadership development initiatives.
- Manage organization-wide engagement and retention programs.
- Mentor future leaders within Quality and Training functions.
- Quality Score
- Critical Error Rate
- Audit Accuracy
- Compliance Adherence Score
- Quality Leakage Reduction
- Training Effectiveness Score
- Certification Pass Rate
- Speed to Proficiency
- Knowledge Retention Score
- Employee Readiness Index
- Denial Reduction Rate
- Rework Reduction
- Productivity Improvement
- SLA Compliance
- Client Satisfaction (CSAT)
- Net Promoter Score (NPS)
- Revenue Impact from Quality Initiatives
- Cost of Poor Quality (COPQ)
- Employee Engagement
- Attrition Reduction
- Bachelor's Degree
- MBA
- 15+ years of overall experience in US Healthcare and Revenue Cycle Management.
- 8+ years of leadership experience in Quality, Training, Process Excellence, or Operational Excellence.
- Experience leading Quality and Training functions for large healthcare operations.
- Proven success managing multiple clients and large delivery organizations.
- Experience managing 500+ FTE healthcare operations.
- Healthcare BPM/BPO leadership experience.
- Exposure to digital transformation and AI-enabled quality programs.
- Revenue Cycle Management
- Medical Billing
- Patient Access Services
- AR Management
- Denial Management
- Payer Regulations
- Provider and Hospital Revenue Cycles
- Quality Management Systems
- Lean Six Sigma Methodologies
- Audit & Compliance Management
- Adult Learning Principles
- Instructional Design
- Capability Building
- Competency Framework Development
- Coaching & Mentoring
- Strategic Thinking
- Executive Presence
- Change Management
- Stakeholder Management
- Client Relationship Management
- Talent Development
- Epic
- Cerner
- NextGen
- eClinicalWorks
- Workforce Management Platforms
- Learning Management Systems (LMS)
- ASQ Certified Manager of Quality/Organizational Excellence (CMQ/OE)
- PMP Certification
- Certified Training Professional (Preferred)
Required Skills
Quality Quality Assurance Capability Development Training Process Excellence
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