The Director of Medical Coding will lead a highperforming organization of approximately 700 FTEs spanning the Philippines and India. This leader will drive operational excellence, coding quality, cost efficiency, productivity, workforce strategy, and continuous transformation initiatives. The role integrates clinical expertise, financial acumen, automation enablement, and large-scale operations management.
Strategic & Operational Leadership
- Provide senior leadership across clinical operations and medical coding teams in PH & India.
- Oversee daily operations, workforce planning, forecasting, and resource allocation for 700+ FTEs.
- Ensure operational performance meets or exceeds established SLAs, KPIs, quality, cost, and productivity targets.
- Lead transformation initiatives, including automation adoption, process optimization, tools enhancement, and analytics-driven operations.
- Drive clinical-financial decision-making; apply strong mathematical and analytical capability to improve coding accuracy, cost outcomes, and data quality.
- Ensure PH holiday alignment and shift coverage (Hybrid | 4PM1AM).
Clinical & Coding Excellence
- Oversee US healthcare coding operations with strong emphasis on coding accuracy, clinical integrity, and regulatory compliance.
- Develop and enforce coding guidelines, audit structures, and continuous quality improvement programs.
- Support a pipeline of PHRN talent willing to pursue medical coding certification (with training bond structure).
- Ensure smooth handling of escalations and high-complexity clinical/coding issues.
People Leadership & Workforce Management
- Provide leadership to multiple layers of management including supervisors, managers, and senior coding specialists.
- Lead talent development, succession planning, and capability building.
- Foster a culture of problem-solving, critical thinking, accountability, and performance.
- Ensure seamless knowledge transfer across functions and regions
Transformation, Tools & Automation
- Champion automation, workflow tools, and digital enablement to improve speed, accuracy, and operational efficiency.
- Drive data-driven decisions through dashboards, reporting insights, and performance analytics.
- Guide teams to be tools-savvy to enhance productivity and reduce manual error rates
Stakeholder Engagement & Reporting
- Prepare and deliver performance, quality, financial, and operational insights to senior leadership.
- Manage cross-functional collaboration (Clinical, Finance, Quality, Workforce, Technology, Transition Teams).
- Conduct business reviews with global stakeholders and support alignment with enterprise clinical/financial objectives.
- Lead escalations and ensure timely resolution with comprehensive documentation
Compliance & Governance
- Ensure adherence to healthcare regulations, coding standards, data integrity requirements, and organizational compliance.
- Uphold quality and risk mitigation protocols across all operations.
- Maintain alignment with company policies including reassignment, shift adjustments, and flexible work directives.
Required
- Bachelor's Degree in Nursing (PHRN preferred).
- Strong clinical background; willingness to pursue medical coding certification (company-sponsored with training bond).
- Minimum 58 years of senior leadership experience in healthcare operations, medical coding, or clinical services.
- Proven strong clinicalfinancial acumen, mathematically inclined, with ability to analyze cost, productivity, and coding/quality metrics.
- Savvy in tools, automation, workflow systems, and digital transformation initiatives.
- Strong experience in handling large-scale operations (preferably 500+ FTEs).
- Excellent problem-solving and analytical skills.
- Experience in multi-country or multi-site leadership (PH & India preferred).
- Strong communication skills with ability to influence senior leaders and cross-functional partners.
- Ability to work onsite hybrid during 4PM1AM PH shift and PH holiday calendar.
Preferred
- Previous leadership experience in US healthcare coding, RCM, clinical operations, or clinical BPO.
- Experience developing coding teams, including managing certification pathways.
- Demonstrated success in managing quality, cost, & productivity transformation programs.
