Associate Director – Medical Coding
Requisition Number: 2322540
Job Category: Business Operations
Primary Location: Hyderabad, Telangana, India
About Optum
Optum is a global organization committed to improving health outcomes through data, technology, and care integration. Our mission is to help people live healthier lives and make the health system work better for everyone. Join us and be part of a culture built on inclusion, growth, and innovation — where your work directly contributes to improving health at a global scale.
Position Summary
The Associate Director – Medical Coding will oversee the design, implementation, and optimization of coding quality programs. This role ensures compliance with regulatory standards, drives operational efficiency, and manages large cross-functional teams in healthcare operations.
Primary Responsibilities
Develop and implement strategies to improve departmental accuracy, efficiency, and quality.
Analyze audit findings and address noncompliance issues.
Collaborate with supervisors to develop best practices and quality communication frameworks.
Implement proactive solutions to mitigate risks impacting project quality.
Review operational reports and performance data to identify improvement areas.
Participate in team meetings to discuss quality trends and corrective measures.
Ensure adherence to company policies, compliance standards, and employment terms.
Functional Competencies
1. Medical Coding Quality Programs & Strategies
Design and manage quality improvement plans aligned with regulatory and payer requirements.
Integrate client contracts, payer policies, and coding guidelines into operational frameworks.
Optimize coding workflows for compliance, scalability, and efficiency.
Provide strategic guidance to cross-functional teams (coding, operations, compliance).
2. Performance Monitoring & Evaluation
Track coding accuracy, audit outcomes, and compliance metrics against SLAs and benchmarks.
Utilize dashboards and scorecards to monitor trends and highlight improvement areas.
Validate data accuracy and provide strategic insights for performance forecasting.
3. Stakeholder Relationship Management
Build strong relationships with coding, compliance, clinical, and revenue cycle teams.
Lead meetings to review coding quality, audit findings, and corrective action plans.
Communicate guideline updates and regulatory changes to stakeholders.
4. Compliance & Policy Oversight
Maintain current knowledge of ICD-10, risk adjustment, and payer-specific guidelines.
Educate staff on compliance standards and documentation requirements.
Track training completion and report compliance metrics to stakeholders.
5. Operational Efficiency & Financial Performance
Drive continuous improvement through data-driven insights.
Conduct end-to-end workflow testing for compliance validation.
Support budget forecasting, variance analysis, and resource planning.
Assign projects based on team expertise and performance metrics.
Values-Based Competencies
Integrity
Demonstrate and enforce ethical behavior.
Ensure compliance with all laws, regulations, and company policies.
Compassion
Enhance customer experience and promote health outcomes.
Relationships
Recruit, develop, and engage talent.
Foster teamwork, collaboration, and diversity.
Innovation
Implement change initiatives and innovative solutions.
Demonstrate emotional resilience in dynamic environments.
Performance
Drive disciplined, data-based decisions.
Ensure operational excellence and clear execution.
Required Qualifications
13+ years of leadership experience managing large cross-functional teams in healthcare operations.
12+ years of specialized experience in Medical Coding, with strong expertise in Risk Adjustment (RA) standards and methodologies.
Proven success in clinical case reviews and RA coding audits ensuring regulatory compliance.
Experience in Risk Adjustment Coding, Clinical Investigations, Revenue Cycle Management (RCM), and Provider Coding.
Demonstrated P&L management skills and operational cost optimization experience.
Proven ability to lead teams of 350+ FTEs, fostering accountability and continuous improvement.
Strong project management experience — planning, execution, and delivery of strategic initiatives.
Our Commitment
At UnitedHealth Group, we are dedicated to equity, inclusion, and sustainability. We work to remove barriers to health equity, address disparities, and ensure access to care for all — regardless of race, gender, age, or background.
How to Apply
Interested candidates can apply through the official Optum careers portal.
Location: Hyderabad, Telangana, India
Category: Business Operations
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