BCBS of Michigan identified six dimensions of ICD-10 neutrality that include payment (Provider), Benefit (Member), Revenue (Payer), Clinical (Programs), Operational (Servicing) and Financial (Overall). As organizations ICD-10 remediation projects move forward, the need to understand and address the “neutrality work stream” seems to be getting more attention.
I can across a job description for an “ICD-10 Operational Stability Manager” and thought it captured the key responsibilities and skills such a position demands.
What Does an Operational Stability Manager Do?
Develops an operational stability plan outlining risks, options and recommendations for defining acceptable performance variances as well as recommendations for action associated with each variance exception.
Oversees the neutrality work stream, including serving as the lead contact for a planned external business partner engagement.
Develops a neutrality plan outlining risks, options and recommendations for defining acceptable variances of neutrality as well as recommendations for positioning organization for future competitive advantage optimization.
Develops an execution plan and management of appropriate staffing resources necessary for the execution of the elements of the neutrality plan that Horizon agrees to implement.
Analysis of business processes, product lines and key performance metrics impacts that the ICD-9 to 10 migration will create.
Develops tolerance definitions, modeling of potential outcomes and analysis of results and determination of potential business changes to ensure variances are within acceptable limits.
Manages the team to monitor continuity thresholds during and post implementation in partnership with the neutrality project.
Accountable for supporting the Operational Stability and Neutrality works treams within the larger ICD-10 program.
Requires understanding of metrics identification development and monitoring.
Requires broad understanding of the impacts of ICD-10 across the organization including financial/claims payment processes.
Proactive monitoring of key indicators is in place prior to the implementation date and solutions (including root cause analysis) are found for identified issues post-production.
Manages the team to monitor neutrality thresholds during and post implementation in partnership with the business continuity project.
Creation of an RFP and selection of an external business partner for development of tolerance definitions, modeling of potential outcomes and analysis of results and determination of potential business changes to ensure variances are within acceptable limits.
If this describes you or someone you know – and you are looking for a new opportunity – send me an email and I can share a lead I have with you.