Manager of Insurance Verification, Enterprise RCM

The Manager of Enterprise Insurance Verification serves as a strategic leader and resource for the growth and development of the enterprise insurance verification department. The position is responsible for providing strategic leadership to the on-shore and off-shore Insurance Verification department. The position is also responsible for the high level managerial and operational lead for strategic initiatives.

Core Competencies

•Leadership – Strong communication and leadership skills, while acting as a role model and coaching team members in USPI core values.

•Interpersonal Skills – The ability to establish oneself as a trusted partner for counterparts; to effectively communicate and engage with all stakeholders of the organization, including physician and health system partners.

•Business Acumen – Effective communication (listening, written and verbal),problem solving, negotiation, positively influencing others, decision making, and time management.

Change Management – The ability to help counterparts through difficult transitions to a new process, workflow, or situation.

•Motivation/Drive – Demonstrates a desire for continuous learning. Self-starting and going beyond what is asked to take on new challenges and create innovative solutions.

•Analytical Skills – Expertise with advanced MS Excel functions; demonstrated mathematical / analytical aptitude; ability sufficient to work in a data-heavy environment and to identify trends.

•Adaptability/Flexibility – Ability to handle multiple tasks, meet deadlines, and redirect when necessary to best serve the Client.

Work Environment

The position may requires some travel to Hospital Client sites, both local and long distance.

Essential Duties and Responsibilities

•Sets best practice standards and operating procedures for insurance verification functions. Helps operationally drive and own insurance verification related regulations and policies.

•Manages day-to-day operations and personnel in planning and facilitating efficient insurance verification services to ensure quality and customer satisfaction. (i.e., program development, process improvement, etc.)

•Partners with Client’s management team and appropriate stakeholders to perform detailed reviews of revenue cycle and operational metrics as it relates to insurance verification.•Prepares, analyzes, monitors, and communicates financial and statistical reports to appropriate business entity.

•Delivers ongoing training and development support to Client’s Business Office leadership and staff.

•Challenges the best practices and seeks opportunities to drive process improvements

•Develops and implements action plans to address and improve deficiencies in process and performance as identified.

•Collaborates with on-site resources in service delivery and problem solving to maximize solution offering and client satisfaction.

•Participates with providing comprehensive, succinct updates to USPI Leadership in order to drive awareness of any Client support requirements and/or risks that could impact service delivery.

•Performs other duties as assigned by V.P., Revenue Cycle-Business Operations and Senior Director as required to meet the business needs of USPI and other stakeholders.

Job Behavior

Employee should demonstrate the ability to work as a team member among multiple departments. Employee must be able to communicate directly and professionally. This person is flexible, reliable, productive, and self-motivated, and maintains professional conduct and appearance. Employee will respect the confidentiality of patients, coworkers and center staff.

USPI’S EDGE™ (Every Day Giving Excellence)

USPI’S EDGE™ is the key to the differentiation of USPI as a customer-focused company. The process of completing EDGE™ requirements establishes processes and measurements that are collected, assimilated, and shared throughout USPI. All employees are involved with EDGE™. The involvement can range from doing their jobs to taking on the role of gathering and/or entering data into the computer. All employees shall at some time during their employment be required to participate in the EDGE™ program.

Health Insurance Portability and Accountability Act of 1996

Responsible for knowing the processes involved assuring the standards established by HIPAA, and ensuring they are followed including the practices and records relating to the use and disclosure of Protected Health Information.

Required Experience:

•Bachelor’s Degree or equivalent demonstrated academic achievement.

•Minimum of 5 Years of Revenue Cycle Management experience.

•Minimum 2 years of management experience.

•Strong understanding of Revenue Cycle Operations within a hospital setting and/or demonstrated, relevant knowledge.

•Proven success in project management roles, to include developing and implementing business initiatives.

•Understanding of the industry trends, market dynamics, and key performance indicators.

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.