Job Summary:
Actively oversees and monitors teams work adheres to legal, compliance, and reporting standards, overseeing implementation of feedback from team and per leader approval. Oversees the completion of research and analysis of highly complex financial data; monitors complex assigned area(s) on the proper use of expenditures. Oversees the management of inquiries from providers, members, attorneys, and other stakeholders; manages project execution and identify business needs with others to implement highly complex process improvement efforts. Oversees the analysis of data, performing follow-ups as needed and reviews recommendations. Oversees teams quality and provides recommendations and analysis to leadership. specialized coaching to all audience(s). Collaborates with stakeholders to develop long-term plans for process improvement with cross-organization impact. Maintains and manages vendor relationships and oversees resolution quality issues.
Essential Responsibilities:
Creates and advocates for developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; works with leaders and employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; hires, trains, and develops talent for growth opportunities; strategically evaluates talent for succession planning; sets performance management guidelines and expectations across teams / units. Oversees implementation, adapts, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends; shares best practices within and across teams. Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams; motivates teams to meet business objectives. Delegates tasks and decisions as appropriate; provides appropriate support, guidance and scope; encourages development and consideration of options in decision making; fosters access to stakeholders.
Manages designated units or teams by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed; partners with key stakeholders and business leaders to ensure products and/or services meet requirements and expectations while aligning with departmental strategies. Aligns team efforts; builds accountability for and measuring progress in achieving results; assumes responsibility for decision making; fosters direct reports to resolve escalated issues as appropriate. Communicates goals and objectives; incorporates resources, costs, and forecasts into team and unit plans; ensures matrixed resources are fulfilling service or performance requirements across reporting lines. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams and units to operate in alignment with operational and business objectives.
Ensures the organizations work is in compliance by: actively overseeing and monitoring the teams work while implementing new practices to ensure they adhere to federal and state laws, and applicable compliance standards, and reviewing the monthly quality reports to leadership, and escalating unresolved issues to senior management.
Ensures accurate patient accounts by: overseeing the management of inquires from providers, members, attorneys, and other insurance personnel to answer a wide range of highly-complex billing questions and evaluating new systems.
Manages the denial process by: leading a teams highly-complex work of performance affecting denials and ensuring effective remediation and taking the teams data analysis and drawing conclusions including risks when making recommendations while also ensuring the teams complete remediation activities.
Ensures finances are completed accurately by: working within allocated budget for complex assigned area by monitoring usage and ensuring proper use of expenditures.
Manages performance management initiatives by: monitoring complex metrics associated with the teams work meets established performance levels while exercising tact and sensitivity in coaching to deliver performance improvement and analyzing financial data and creating complex solutions that require ingenuity, and are used by others to generate reports for relevant departments and medical centers to assess performance progress. uses advances knowledge to ensures quality to oversee performance to enable decision making by providing feedback and driving the implementation of complex strategies to ensure vendor performance of collections, coding services, systems, coverage validation, income verification, reviewing and validating invoices.
Manages process management initiatives by: using advanced knowledge of the field and critical information from other diverse areas to plan process improvement projects and identify business needs with operations managers, IT, clinicians, and health plan managers while also implementing long-term, complex planning to translate business needs into project requirements that are then used to develop project specifications and action plans.
Manages project management initiatives by: manages project execution and management efforts by leading team members to collaborate with stakeholders across functions and/or entities to ensure the project is successfully executed and project-based changes are implemented.
Leads regulatory reporting by: researching, recommending, and ensuring regulation standards are incorporated into complex reporting processes and managing regulatory extracts while also implementing and recommending changes.
Facilitates with vendor relationships by: maintaining and managing relationship with vendors by working with senior internal and external contacts to manage execution of work in accordance with organizational guidelines while also seeking and using advanced knowledge to recommend complex regional procedures, guidelines, strategies, and methods for managing vendor relationships.
Manages systems management initiatives by: collecting feedback, providing training, communication, and facilitating the review, validation of the build, preview and comment on adoption of new complex systems updates for highly-knowledgeable teams and escalates complex issues to senior management.
Facilitates training delivery by: facilitating and delivering complex training, determining training priorities and training delivery methods based on policies, audit findings, and work curriculum.
Manages the training development process by: using multidisciplinary knowledge of several relevant fields and critical, complex information from other diverse areas to identify education and training requirements that reflect revenue cycle changes to develop strategic training content and providing approval.
Minimum Qualifications:
Minimum three (3) years of experience in a leadership role with direct reports.
Bachelors degree in health care administration, business administration, or related field AND a minimum of three (3) years of experience in data analytics, merchant services, clinic/hospital operations, banking, health care billing and collections, or relevant experience OR Minimum six (6) years of experience in data analytics, merchant services, clinic/hospital operations, banking, health care billing and collections, or relevant experience.
Additional Requirements:
COMPANY: KAISER
TITLE: Senior Manager, Revenue Cycle / Patient Accounts
LOCATION: Fontana, California
REQNUMBER: 1368620
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
