Leprechaun HCC Management · Leprechaun, LLC · Phone (817) 231-7000 · Fax (817) 231-7099

Careers

We are presently seeking well-qualified applicants for the following positions:

Leprechaun™ offers competitive salaries and benefits. All positions are based in Fort Worth, TX.

To apply for one of these positions, please send your resume and cover letter to careers@lepmed.com.




Medical Coder
Review of scanned medical record for documentation related to disease or symptoms and diagnostic descriptions for a given encounter. Demonstrate knowledge and ability to assign ICD-9 CM codes to the highest specificity ensuring that diagnostic codes and documentation accurately reflect and support the visit encounter. All coders must maintain a 95% accuracy rate.

Responsibilities

  • Ability to daily review scanned provider charts and assign ICD-9 CM codes based on documentation in chart.
  • Ability to identify and report to immediate manager issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding guidelines.
  • Maintain consist daily production of greater than 40-60 reviews per day.
  • Demonstrate the ability to appropriately use coding principles to code to the highest specificity using ICD-9 CM coding books as well as other industry wide manuals that are recognized by American Health Information Management Association (AHIMA).
  • Analyzes Complete Code product line, ensure that documents are accurate and comprehensive and correctly inputs information into tool.
  • Performs other duties and responsibilities as required

Education and Formal Training - Certified Medical Coder

  • A National Certification issued by the American Health Information Management Association; such as Certified Professional Coder (CPC), Certified Professional Coder Apprentice (CPC-A) or Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Based CCS-P, Certified Coding Associate (CCA), or
  • Registered Health Information Administrator (RHIA), or Registered Health Information Technologist (RHIT) with greater than 6 months experience coding ICD-9 CM.

Experience

  • Minimum of 1year experience use ICD-9 CM Coding in a Providers' office and/or hospital coding setting.
  • Certified Professional Coder Apprentice (CPC-A) must have at least 6 months to 1 year experience with provider office coding and/or hospital coding setting.

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Clinical Reviewer 1
This position is responsible for conducting clinical chart audits for the purpose of identifying and submitting documented diagnoses to Medicare for client members of Medicare Advantage plans. The position has the potential to interact with a variety of internal and external clients including health care executives, physicians, provider office personnel and hospital staff. This position requires high level interpersonal skills.

Essential Duties and Responsibilities

  • Performs accurate chart reviews to identify and submit appropriate codes for submission to Medicare.
  • Records findings completely and accurately in accordance with policy and procedures.
  • Maintains documentation consistent with CMS regulations, company goals and policies.
  • Maintains frequent and regular contact with supervisor.
  • Seeks assistance, supervision or consultation when appropriate.
  • Participates in personal annual performance evaluation, providing input into opportunities for growth and development.
  • Reviewer is at their workstation ready to start work at their scheduled start time and demonstrates adherence to their schedule.
  • Performs other duties and responsibilities as required.

Principal Working Relationships

  • Works closely with Manager in areas of position responsibility.
  • Works closely with client based team personnel to meet workflow requirements.

Qualifications

  • Must have attained a baseline 1,000 codes with minimum 95% accuracy in HCC coding.

Education and Experience

  • Must have current Texas Nursing license.
  • Must possess good writing and verbal communication skills.
  • Must be able to pass computer competency skills test.
  • Must have previous ICD 9 coding experience.
  • Previous experience with Medicare guidelines desired.

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Manager, Vendor Services
Manage the interface between vendors and/or other outsourced entities (collectively "vendor") and the company. Coordinate high level projects and initiatives between Leprechaun and its vendors and assist in the research and incorporation of new vendors into Leprechaun's Outsourcing & Scanning Services department's list of qualified vendors. Manage projects and oversee vendor and outsourced services purchased by Leprechaun for its business needs and to service its clients.

Essential Duties and Responsibilities

  • Supervisory duties and responsibilities include:
    • a) writes and conducts annual performance appraisals and ensures regular feedback, coaching, and communication with group; b) ensures high level of performance standards and achievement to meet company needs and business goals; c) provides development opportunities for staff to broaden and enhance skills and abilities; d) administers company policies and procedures; e) ensures compliance with safety policies and good housekeeping; f) manages initial training of new employees and ongoing training as required; and g) promotes an environment that fosters team work and commitment to satisfy customer requirements.
  • Work with internal Leprechaun stakeholders to determine service management needs.
  • Perform market analyses to identify vendors to satisfy Leprechaun's service management needs.
  • Complete preliminary screens of vendors to confirm capability, capacity, legitimacy, and fit.
  • Manage request for proposal (RFP) process for qualifying vendors for inclusion in Leprechaun's list of qualified vendors.
  • Coordinate statement of work bidding processes and awarding of SOWs to vendors.
  • Perform ongoing checks to confirm vendor eligibility for inclusion in Leprechaun's list of qualified vendors.
  • Set performance requirements and metrics for vendor's for ongoing inclusion in Leprechaun's list of qualified vendors.
  • Work with Leprechaun team to complete ongoing enhancements to the RFP and SOW documents and processes.
  • Facilitate contracting process and execution of documents with approved vendors.
  • Work with IT and Reporting Departments to confirm receipt of data and preparation of reports.
  • Communicate Quality Assurance requirements to vendor.
  • Oversee vendor interface with Leprechaun on all products and services.
  • Create and administer vendor project management plans.
  • Coordinate and ensure regular and ongoing detailed vendor reporting on all projects following consistent reporting metrics and specifications.
  • Oversee vendor interface with Leprechaun and coordinate vendor projects with other departments.
  • Coordinate and lead regular internal and external communications and meetings with vendors.
  • Prepare vendor project status reports and final project summaries.
  • Secure and audit vendor invoices; ensure accurate and timely payment.
  • Coordinate invoice figures with Accounting; ensure sufficient information for accurate client invoicing.
  • Monitor client reporting on financial and other metrics; ensure outsourcing functions complement company and client goals.
  • Monitor and report vendor compliance with contract. Works closely with Director in areas of position responsibility.
  • Works closely in mentor and leadership role with Outsourcing Services Representatives.
  • Works closely with department personnel to meet workflow requirements.
  • Works closely with Manager, Quality Assurance on status of vendor meeting quality requirements.

Qualifications

  • Bachelor's degree from four-year college, or university, or one to two years related experience, and/or training or equivalent combination of education and experience. Masters preferred.
  • Healthcare and/or Managed Care experience. CMS and/or Medicare MCO experience beneficial.
  • Account management and financial management experience preferred.

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Software Quality Assurance Release Coordinator

  • Evaluate and lead all new release strategies and processes utilizing revision control tools such as Microsoft Visual SourceSafe or Visual Studio Team Foundation Server.
  • Ownership of the logical revision processes and procedures to build and move code releases from the Development environments, to QA and then on to Production.
  • Provide cross functional release management leadership for large, complex code rollouts, while also delivering critical feature and maintenance driven updates for all Leprechaun products.
  • Coordinate and conduct Release Kickoff Meetings to define overall scope of all Release Packages.
  • Coordinate the development of detailed rollout plans, while identifying risk areas and mitigations plans.
  • Detailed monitoring and tracking of all release processes, milestones and dependencies in coordination with the Project Management Office and Senior Management Team.
  • Evaluate and implement rollout guidelines and strategies for all internal and external releases.
  • Identify and implement necessary internal tools for product launch and reporting.
  • Educate internal and external cross functional teams on release management process.
  • Ability to work closely and conduct meetings with all levels of management within the organization.
  • Develop expertise in the features/product areas owned by your team, and using that expertise to advocate on behalf of the customer in feature release team meetings. This also involves a constant oversight of a unique requirement in on-demand web services model - assuring that changes to existing functionality are truly required and correctly deployed.
  • Assisting your team in the execution of test plans, test cases/scripts, and bug reports assessing quality and associated risk.
  • This position requires a healthy dose of initiative and the ability to remain flexible and responsive in a dynamic environment.
  • Provide leadership to the SQA team on the practical application of software release testing activities to reduce the number of defects that impact production operations.
  • Technical Support for all Internal and External Application Users.
  • Responsibility for entire Release Management Process.
  • Execution of Manual and Automated Test Functions and Test Management processes utilizing Compuware and/or Mercury Interactive Test Tool Suites.
  • Participate in the business and technical requirements engineering process.
  • Write technical and functional documentation.
  • Provide work estimates on effort and produce management estimates and reports.

Qualifications and Relevant Skills

  • Bachelor's Degree. A BS in CS or EE preferred.
  • Working knowledge of MS Project. PMP Certification preferred.
  • Professional SQA Certification(s) preferred.
  • Excellent, hands-on working knowledge of the Microsoft Visual SourceSafe or Visual Studio Team Foundation Server tools.
  • Excellent verbal and written communication skills, analytical skills, and organizational ability.
  • Previous Release Management Implementation in a dynamic environment.
  • Internal and External Technical Support Experience.
  • Proven Software Quality Assurance Experience.
  • Working hands-on knowledge of SQL.

Relevant Experience

  • 5 Years experience applying release processes to improve software development activities in large, multi-environment organizations.
  • Experience with healthcare data, claims, clinical data or EDI processing.
  • Strong experience with SQA processes, black box, white box, gray box testing and test case design, scripting and execution and automated test tools.
  • Ability to work on complex testing projects that require a deep understanding of the application logic and dependencies.
  • Demonstrated success developing software release strategies, test cases and test execution results.
  • Proven Release Management Implementation utilizing industry leading tools and processes.
  • Experience with Windows platforms and networks required as well as proven experience with sophisticated Client/Server and workflow solutions.
  • Know and care about what the customer wants from our service - and be willing to stand up for it!
  • Experience in short release cycles, the full software development lifecycle, and have worked on products that were successfully released for public consumption.

Nice to Have

  • Technical Training or MS PowerPoint Presentation Skills
  • Ability to create Automated Test processes utilizing either the Compuware and/or Mercury Interactive Suite of Test Tools.
  • Experience with report development for Healthcare (CMS) environment
  • Knowledge of CMS and the HCC System

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Software Quality Assurance Release Manager

  • Provide cross functional release management leadership for large, complex code rollouts, while also delivering critical feature and maintenance driven updates for all Leprechaun products.
  • Coordinate and conduct Release Kickoff Meetings to define overall scope of all Release Packages.
  • Coordinate the development of detailed rollout plans, while identifying risk areas and mitigations plans.
  • Detailed monitoring and tracking of all release processes, milestones and dependencies in coordination with the Project Management Office and Senior Management Team.
  • Evaluate and implement rollout guidelines and strategies for all internal and external releases.
  • Evaluate and lead all new release strategies and processes.
  • Identify and implement necessary internal tools for product launch and reporting.
  • Educate internal and external cross functional teams on release management process.
  • Ability to work closely and conduct meetings with all levels of management within the organization.
  • Develop expertise in the features/product areas owned by your team, and using that expertise to advocate on behalf of the customer in feature release team meetings. This also involves a constant oversight of a unique requirement in on-demand web services model - assuring that changes to existing functionality are truly required and correctly deployed.
  • Assisting your team in the execution of test plans, test cases/scripts, and bug reports assessing quality and associated risk.
  • This position requires a healthy dose of initiative and the ability to remain flexible and responsive in a dynamic environment.
  • Provide leadership to the SQA team on the practical application of software release testing activities to reduce the number of defects that impact production operations.
  • Technical Support for all Internal and External Application Users.
  • Responsibility for entire Release Management Process.
  • Execution of Manual and Automated Test Functions and Test Management processes utilizing Compuware and/or Mercury Interactive Test Tool Suites.
  • Participate in the business and technical requirements engineering process.
  • Write technical and functional documentation.
  • Provide work estimates on effort and produce management estimates and reports.

Qualifications and Relevant Skills

  • Excellent verbal and written communication skills, analytical skills, and organizational ability.
  • Previous Release Management Implementation in a dynamic environment.
  • Internal and External Technical Support Experience.
  • Proven Software Quality Assurance Experience.
  • Working hands-on knowledge of SQL.
  • Bachelor's Degree. A BS in CS or EE preferred.
  • Working knowledge of MS Project. PMP Certification preferred.
  • Professional SQA Certification(s) preferred.

Relevant Experience

  • 5 Years experience applying release processes to improve software development activities in large, multi-environment organizations.
  • Experience with healthcare data, claims, clinical data or EDI processing.
  • Strong experience with SQA processes, black box, white box, gray box testing and test case design, scripting and execution and automated test tools.
  • Ability to work on complex testing projects that require a deep understanding of the application logic and dependencies.
  • Demonstrated success developing software release strategies, test cases and test execution results.
  • Proven Release Management Implementation utilizing industry leading tools and processes.
  • Experience with Windows platforms and networks required as well as proven experience with sophisticated Client/Server and workflow solutions.
  • Know and care about what the customer wants from our service - and be willing to stand up for it!
  • Experience in short release cycles, the full software development lifecycle, and have worked on products that were successfully released for public consumption.

Nice to Have

  • Technical Training or MS PowerPoint Presentation Skills
  • Ability to create Automated Test processes utilizing either the Compuware and/or Mercury Interactive Suite of Test Tools.
  • Experience with report development for Healthcare (CMS) environment
  • Knowledge of CMS and the HCC System

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Business Analyst
Responsible for analyzing business needs, designing and writing functional requirements and programming specifications. Codes, tests, and certifies the integrity of proposed automated solutions, and assists in implementation activities.

The primary focus of Business Systems Analyst is to analyze and translate business requirements in a form that can easily be understood by all audiences (Corporate IT, Business Units, and Management). In addition, the Business Systems Analyst identifies all system constraints, implications, and consequences of various system changes. Business Systems Analysts identify specification changes for programming staff.

Essential Duties and Responsibilities

  • Develop functional requirements for application development and/or modification
  • Analyze and evaluate current systems to determine required changes to support applications and processing needs
  • Provide strategic advice to clients and project managers by defining and/or developing business processes and researching and identifying enabling systems/technologies
  • Prepares programs requiring a wide variety and extensive number of internal processing actions
  • Document program code and processes

Qualifications

  • Bachelors degree is a + but not required
  • 3+ years as a Business Analyst in an IT Development arena
  • MS SQL knowledge. Basic T-SQL, and database structures -not required to write scripts
  • Excellent MS Office skills -Word, Excel, PowerPoint, Visio
  • Healthcare experience a plus
  • Ability to facilitate and lead meetings -Business Requirements, Implementation Strategies, Status Reports

Material and Equipment Directly Used

  • Microsoft Office Suite
  • Outlook
  • Visio
  • MS SQL

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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CMS Knowledge Specialist
This position will involve remaining current on CMS guidelines and requirements and develop communication and education for clients and staff which will explain how guidelines and requirements will impact their work. This subject matter expert will also work to develop presentations, e-mail announcements, and other forms of communication required to meet Leprechaun and individual clients' needs concerning CMS regulations. The role will include interpreting CMS guidelines and regulations related to chart reviewing and member evaluations. This position will also be required to keep current on CMS changes and updates and communicate them to staff and clients in a polished and professional manner.

Essential Duties and Responsibilities

  • Subject matter expert duties and responsibilities include:
    • a) monitoring CMS publications for new guidance and coaching the staff on changes and potential changes and how to communicate those changes to all parties; b) oversee staff on their comprehension of the HCC Risk adjustment program; c) provides remedial guidance for current employees that have not mastered the HCC risk adjustment program content knowledge; d) develop a comprehensive training program for the Client Services Account Managers.
  • Client and organization facing - expert in CMS.
  • Understand business of health plan customers.
  • Familiar with industry standard coding practices and modifications.
  • Prior experience and working knowledge of MA program and DRGs.
  • Watch across industry for ICD-9 updates.
  • Facilitate and organize participation in CMS communications.
  • Procure, organize, and disseminate yearly updates from CMS.
  • Ability to answer client questions.

Education and Experience

  • Bachelor's degree required, Master's degree preferred.
  • Minimum of 5 years of Healthcare and/or Managed Care experience. Experience in CMS or Medicare CMO required.
  • Must have good working knowledge of the CMS HCC risk adjustment program
  • Demonstrated communication skills.
  • Demonstrated excellence in problem resolution and experience in translating high level concepts.
  • Demonstrated success in developing strategies for client to implement programmatic changes.
  • Demonstrated record of providing a high standard of customer service and satisfaction.
  • Travel up to 30%

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Manager, Quality Assurance
Manage the quality assurance ("QA") activities and staff specific to vendors and outsourced entity (collectively "vendor") services and Leprechaun scanning projects under the domain of the Outsourcing & Scanning Services Department.

Essential Duties and Responsibilities

  • Write and conduct annual performance appraisals and ensures regular feedback, coaching, and communication with group.
  • Ensure high level of performance standards and achievement to meet company needs and business goals.
  • Provide development opportunities for staff to broaden and enhance skills and abilities.
  • Administer company policies and procedures.
  • Ensure compliance with safety policies and good housekeeping.
  • Manage initial training of new employees and ongoing training as required.
  • Promote an environment that fosters team work and commitment to satisfy customer requirements.

Additional Responsibilities

  • Create and adhere to company quality assurance program, set metrics for assessment.
  • Create and administer QA project management plans by vendor, service, project, and client.
  • Monitor and report on QA programs by vendor, service, project, and client.
  • Contribute QA requirements to vendor contracting process.
  • Coordinate and lead regular internal and external QA communications including meetings.
  • Oversee QA training programs.
  • Oversee vendor QA programs including onsite audits, reviews, corrections.
  • Coordinate QA functions with Chief Quality Officer and VP Professional Services.

Essential Activities

  • Supervise and manage staff within QA division of Outsourcing & Scanning Services Department.
  • Create and adhere to company quality assurance program; set metrics for assessment.
  • Create and administer QA project management plans by vendor, project, client.
  • Monitor and report on quality assurance programs by vendor, project, client.
  • Oversee vendor Quality Assurance programs including onsite audits, reviews, corrections.

Education and Formal Training

  • Bachelor's degree from four-year college, or university, or one to two years related experience, and/or training or equivalent combination of education and experience.

Experience

  • Healthcare and/or Managed Care experience. CMS and/or Medicare MCO experience beneficial.
  • Quality Assurance background required.
  • Travel: 25%.
  • Valid and current drivers license with a good driving record.

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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Product Manager
The Product Manager is responsible for the product planning and execution throughout the product lifecycle, including: gathering and prioritizing product and customer requirements, defining the product vision, product specifications, product pricing, market sizing, distribution channels and training support for product rollout. The Product Manager is responsible for overseeing the entire product development process (PLM). This person works directly with the Sales Team on product development. This position works closely with Finance on production planning to ensure profitability. This position works closely with IT, Client Services, Sales and Marketing and Vendor Services to ensure revenue and customer satisfaction goals are met. This position closely monitors product performance. The Product Manager's job also includes ensuring that the product supports the Company's overall strategy and goals.

Additionally, the Product Manager supervises an Assistant Product Manager. Supervisory duties and responsibilities include: a) writes and conducts annual performance appraisals and ensures regular feedback, coaching and communication with group; b) ensures high level of performance standards and achievement to meet company needs and business goals; c) provides development opportunities for staff to broaden and enhance skills and abilities; d) administers company policies and procedures; e) manages initial training of new employees and ongoing training as required; f) promotes an environment that fosters team work and commitment to satisfy customer requirements. Performs other duties and responsibilities as required.

Overall Responsibilities

  • Develop and implement the company's marketing and two year product plans through extensive product rationalization and competitive analysis.
  • Manage the product development process, and work closely with Marketing, Design Operations, and Sales to deliver products to market on time.
  • Manage product timelines and perform other product management functions.
  • Ongoing category analyses including forecasting and financial performance (P&L) and projections.

Qualifications

  • Quantitative and analytical skills.
  • Demonstrated success defining and launching products.
  • Excellent written and verbal communication skills.
  • Extensive knowledge of consumer products and product management.
  • Quantitative and analytical skills are essential (financial/P&L knowledge).
  • Exceptional attention to details and follow through.
  • Proven ability to act/think independently, exercise judgment, and motivate people .
  • Excellent teamwork skills.
  • Proven ability to act/think independently
  • Proven ability to influence cross-functional teams
  • Ability to perform in a high-pressure deadline oriented environment
  • Working knowledge of Medicare HCC Risk Adjustment preferred

Knowledge, Skills and Abilities

  • Must be a good organizer, meticulous, and a good public speaker at ease with moderating large groups.

Education and Formal Training

  • Master's degree (M.A.) strongly preferred. Bachelors degree required.

Experience

  • Five or more years experience in a Medicare or Integrated Healthcare Delivery System. Knowledge of Medicare HCC Risk Adjustment preferred

Other

  • PC
  • Demonstrated proficiency with Microsoft Office products including Word, Excel, PowerPoint, Publisher and Visio.
  • Travel: 30%

To apply for this position, please send your resume and cover letter to careers@lepmed.com.

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