EXL—Senior Manager - Quality

Job description

Description: Experience: - 10–15 years of experience in US Healthcare Medical Coding, Coding Quality, Auditing, or Payment Integrity. - Strong experience managing coding quality programs across multiple specialties and/or complex healthcare processes. - Proven experience in client management, quality governance, process improvement, and operational transformation. - Experience with coding audits, root-cause analysis, quality analytics, performance benchmarking, and corrective action planning. - Experience leading large teams and mentoring coding auditors, SMEs, and quality professionals. - Exposure to Lean/Six Sigma, automation, analytics, and technology-enabled quality improvement initiatives is preferred. Requirements: - Bachelor’s degree in Life Sciences, Healthcare, Nursing, or a related discipline. - Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification preferred. - Lean Six Sigma certification (GB/BB) preferred. - Strong knowledge of ICD-10-CM, CPT, HCPCS, NCCI, CMS guidelines, payer policies, and applicable coding regulations. Communication Skill: Must have excellent communication and interpersonal skills Working Hours: Mid shift Work Model: Hybrid - Should be able to work from office at least for the first 6 months. Telecommuter/Internet requirements, if applicable: Wi-Fi with excellent bandwidth, uninterrupted power (power back up) Responsibilities: - Drive coding quality governance and process management to consistently meet or exceed client SLAs, quality targets, and contractual requirements. - Partner extensively with clients to understand coding requirements, establish quality benchmarks, define performance baselines, and set appropriate quality targets. - Develop and execute coding quality strategies, audit frameworks, and continuous improvement programs aligned with client and business objectives. - Lead root-cause analysis of coding errors and drive corrective and preventive actions to improve accuracy and reduce repeat defects. - Oversee quality dashboards, trend analysis, sampling methodologies, audit outcomes, and performance reporting to identify improvement opportunities. - Act as the key business interface between client quality/transformation teams and EXL Operations, Quality, Analytics, Technology, and Transformation teams. - Build strong relationships with key client stakeholders and influence decision-making through data-driven insights and quality improvement recommendations. - Drive standardization and adoption of coding best practices across processes, specialties, and client engagements. - Promote a Lean Six Sigma culture and use quality tools and methodologies to improve process efficiency, accuracy, and customer outcomes. - Mentor and develop quality leaders, auditors, SMEs, and Lean Six Sigma professionals to build a strong quality capability. - Lead quality transition and implementation activities for new processes, including requirement gathering, quality framework design, audit plan development, and implementation support. - Ensure coding quality programs comply with client requirements, internal governance standards, regulatory guidelines, and relevant industry/certification requirements. - Identify opportunities for automation, analytics, AI, and technology-enabled quality improvements in coding processes - Support RFP/RFI responses, solutioning, and business development initiatives by providing coding quality expertise, metrics, governance models, and transformation case studies. - Participate in client visits, governance forums, and executive discussions to showcase quality performance, improvement initiatives, and transformation outcomes. - Facilitate knowledge sharing and benchmarking of coding quality practices across EXL and the broader healthcare industry. - Drive a culture of accountability, continuous improvement, and customer-centricity across the coding quality organization