- Leads and Manages daily team operational workflows, including:
- Submission of documentation requests to physicians
- Successful receipt of medical records/documentation/prescriptions from physicians
- Timely and accurate verification of patient benefits across all payers (Medicare, Medicaid, commercial insurance)
- Timely response to audit/medical record requests
- Documentation management
- Ensures workflows are in compliance with related laws, regulations and company directives
- Utilizes a data driven approach to oversee all workflows of the department that will maximize both production and quality standards
- Analyzes reports, records, and other metrics to confer with staff for efficient planning and staff utilization
- Create new and evolve current processes by identifying opportunities through available reporting metrics to improve profitability and patient satisfaction
- Proactively builds and implements key KPI's to increase quality, financial performance (Doc OPEX goals) and service levels
- Leads and motivates the team for maximum employee engagement
- Provide coaching and feedback to the representatives based on performance levels
- Fosters a collaborative team environment, that is results driven and adheres to the HDIS Core Values: Integrity, Compassion, Excellence, Respect and Commitment to Quality.
- Engages cross-functionally as a go to problem solver, based in knowledge of reimbursed activities in Medicaid and Medicare
- 5-10+ years of operations experience managing/supervising in operations within healthcare industry
- Thorough knowledge and experience of the rules and regulations associated with managed care, insurance, Medicare and Medicaid.
- Brightree Experience preferred
- Experience working in a matrix organization with the ability to manage multiple priorities across various stakeholders and departments
- Advance computer skills and proficiency in MS Excel required; intermediate skills and proficiency in Outlook and PowerPoint required
- Demonstrate a thorough knowledge of the rules and regulations associated with Medicare, Medicaid and commercial insurance organizations
- Strong leadership acumen; problem solving skills, successful team management and development
- Demonstrated strong analytical, quantitative, and logical thinking skills
- Extensive problem-solving capabilities
- Strong written and verbal communication skills
- Attention to details and accuracy along with strong organization skills
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Manager in Training
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Facilities Maintenance Technician I
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Keystone Management Saint Louis, United StatesJob Description · Job DescriptionHave you ever been part of a community or visited a community where you felt like you belonged? You felt heard, seen, and appreciated for who you are and the uniqueness you bring to the community. The people were warm and inviting. Everyone was wi ...
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RN - Oncology Evenings 24 hrs/wk
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RN- Trauma Surgical Weekend Nights
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RN - Trauma Surgical, Nights
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RN - Trauma Surgical, Nights
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Oncology Program Manager
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Mercy Mercy Hospital South, United StatesThe Oncology Program Manager position with be focused on the implementation and coordination of oncology programs. This position is responsible for managing & directing the departments of Cancer Resource Center - patient navigation program and the social work team. He/she will pr ...
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RN - Home Health, Full Time
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