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.
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