- Act as a liaison for the OMS and provide support, education, collaborate, and lead projects with
key stakeholders and internal departments including clinical areas, EHR, Informatics, Middle
Revenue Cycle, Provider Financial Services, Payer Contracting, Compliance, Provider Practice
Services, Credentialing and Provider Enrollment and develop a working knowledge of these
operational areas.- Manage, submit, and track tickets for OMS Operations maintenance work and process improvement projects
- Act as a SME for provider epic SER and blueprint set-up and collaborate on or lead related projects
- Maintain knowledge on provider taxonomy/specialty and lead or assist on projects as the "expert"
- Identify and resolve provider enrollment issues to reduce related claims denials and rejections
- Lead provider enrollment-claims meeting including maintaining electronic project management board
- Collaborate with delegated and non-delegated payers including enrollment issue resolution and interface with the credentialing database analyst to clarify and/or request provider data sent on the delegated reports
- Function as the primary "owner" of the provider EDI table in Epic, keep documentation up to date and oversee and maintain related projects and processes
- Facilitate Medical Staff peer review operations, including FPPE and OPPE, by assisting with data collection and maintenance and providing Medical Staff support
- Manage provider enrollment claims work queues
- Build and maintain metrics reports and dashboards using Power BI and other tools to support the OMS workflows that can be shared with stakeholders to increase transparency, improve efficiency, identify gaps, and solve problems
- Track OMS Operations standard work documents to be used as a resource by internal stakeholders and ensure timely updates
- Serve as the system administrator and provide support for the credentialing and/or peer review database with duties to include: maintaining user access and security; building and maintaining electronic forms; and creating and managing reports
- Oversee the organization of and support the Medical Staff Quality Committee
- Represent the OMS as a Forms Committee member
- Complete ad hoc projects as assigned
- Bachelor's degree with emphasis on research, project management, education, or related field
- An approved equivalent combination of education and experience
- Experience with Cystal Reports
- Knowledge of provider hospital and payer credentialing and enrollment processes
- Experience with MSOW, RLDatix products, or other database management
License/Certifications - Strong oral and written communication skill
- Experience with EPIC Electronic Health Record
- Demonstrated project management skills
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Medical Staff Ops Analyst - Minneapolis, United States - Hennepin County Medical Center
Description
Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical center, a large outpatient Clinic & Specialty Center, and a network of clinics in the North Loop, Whittier, and East Lake Street neighborhoods of Minneapolis, and in the suburban communities of Brooklyn Park, Golden Valley, Richfield, and St. Anthony Village. Hennepin Healthcare has a large psychiatric program, home care, and operates a research institute, philanthropic foundation, and Hennepin EMS. The system is operated by Hennepin Healthcare System, Inc., a subsidiary corporation of Hennepin County.
Equal Employment Opportunities: We believe equity is essential for optimal health outcomes and are committed to achieve optimal health for all by actively eliminating barriers due to racism, poverty, gender identity, and other determinants of health. We are committed to equitable care and working in an environment that celebrates, promotes, and protects diversity, equity, inclusion, and belonging. We are committed to bringing in individuals with new cultural perspectives to assist in creating a more equitable healthcare organization.
SUMMARY:
We are currently seeking a Medical Staff Ops Analyst to join our Medical Administration team. This position is full-time with benefits, 80 hours per pay period, day, Monday - Friday, fully remote.
Purpose of this position: This position is responsible for liaising with internal and external stakeholders to lead and support projects and identify workflow opportunities and improve processes that impact the OMS and Medical Staff, including provider enrollment workflows and billing issues; peer review operations; and will act as a bridge between operational owners and EHR teams.
RESPONSIBILITIES:
QUALIFICATIONS:
Minimum Qualifications:
-OR-
Preferred Qualifications:
Knowledge/ Skills/ Abilities:
You've made the right choice in considering Hennepin Healthcare for your employment. We offer a wealth of opportunities for individuals who want to make an impact in our patients' lives. We are dedicated to providing Equal Employment Opportunities to both current and prospective employees. We are driven to connect talented individuals with life-changing career opportunities, enabling you to provide exceptional care without exception. Thank you for considering Hennepin Healthcare as a future employer.
Please Note: Offers of employment from Hennepin Healthcare are conditional and contingent upon successful clearance of all background checks and pre-employment requirements.
Department: Medical AdministrationPrimary Location: MN-Minneapolis-Downtown Campus Standard Hours/FTE Status: FTE = hours per pay period)Shift Detail: DayJob Level: StaffEmployee Status: Regular Eligible for Benefits: YesUnion/Non Union: Non-Union Job Posting: MayEEO/Disability/Veteran employer.
Medical Staff Ops Analyst professionals in Minneapolis
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Kelly Brabec
Clinical Documentation Integrity Advisor, RN
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Kyle Kramer
Actuarial Analyst