Director, FFS Coding Compliance (Remote)

Optum; Eden Prairie (MN); Remote; USD 135,000 - 231,000; Full time

Job summary

Optum is a global health services company seeking a Director of Compliance for FFS Coding. The role leads cross-functional coding compliance across inpatient, outpatient facility, and professional services, with remote work from anywhere in the U.S.

Minneapolis/DC area may require in-office presence. The successful candidate will oversee audits, training, and policy development, reporting to the VP of Optum Coding Compliance.

Qualifications

• CCS, CPC, RHIT or similar coding certification is required.
• 10+ years of experience with increasing responsibility for FFS coding or related compliance functions.
• Proven experience with auditing, monitoring and provider education.
• Experience with compliance software, EMR systems and coding platforms.
• Experience working with senior executives.
• Deep understanding of outpatient, inpatient and specialty coding, CMS regulations, NCD and LCD guidelines, DRG methodologies.
• Strong communication skills and business acumen.
• Self-starter with proven track record in matrixed environments.
• Collaborative, innovative, accountable and agile team leadership.
• Excellent strategic decision making, analytics, influence and written/verbal communication skills.
• Knowledge of risk management methodologies and tools.

Responsibilities

• Drive compliance strategy for FFS components of the Optum Coding Compliance program.
• Design and execute a risk-based FFS audit plan and oversee remediation.
• Manage coding compliance professionals supporting the program.
• Engage with stakeholders at all levels to evaluate critical FFS processes.
• Administer program oversight and collaborate with leaders to support reviews and corrective actions.
• Establish and maintain oversight standards and suggest improvements.
• Contribute to FFS coding compliance training, policies and communications.
• Collaborate on implementing new FFS coding standards and audits.
• Report FFS coding compliance activities to management.

Skills

Coding certification

Auditing & monitoring

EMR & coding platforms

Executive interaction

Communication

Leadership & team leadership

Analytical thinking

Cross-functional collaboration

Risk management

Job description

Optum is a global health services company seeking a Director of Compliance for FFS Coding. The role leads cross-functional coding compliance across inpatient, outpatient facility, and professional services, with remote work from anywhere in the U.S.

Minneapolis/DC area may require in-office presence. The successful candidate will oversee audits, training, and policy development, reporting to the VP of Optum Coding Compliance.