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Accounting, Actuarial & Finance

Support the Bottom Line — and the Big Picture

Create the financial strategies that affect our patients, medical centers, and future. On this team, you'll provide the strategy recommendations that drive operational and process improvement, as well as face challenging opportunities to influence the future of health care.

Manager Regional Revenue Cycle Operations

Location: City of Industry, CA Additional Locations:
Job Number: 696788 Date posted: 05/22/2018
Description:
The Regional Revenue Cycle Operations Manager is a management position responsible for the operations success of a Regional Revenue Cycle business unit to include Medical Center & Medical Office Center Buildings (MOB). This individual is responsible for assuring the day to day operations in patient access revenue cycle processes supporting Kaiser Permanente's ability to enhance the patient experience & ensure the sustainability of the revenue cycle. Specifically, the Operations Manager is responsible for leadership & management of a Regional Revenue Cycle business unit(s) inclusive of: Medical Financial Assistance Program, including timely review & processing of applications & correspondence. Pre-billing and Billing operations, including management & oversight of work queues in KP HealthConnect to assist in cycle times within defined parameters. Professional Service Coding including management & oversight of work queues in KP HealthConnect (i.e., clearing of Ingenic edits). Late Discover/Subpoena/TPL operations including identification, validation & adding of coverage for Billable Payors, Kaiser Plans, Home Care and Workers' Compensation. The Outreach Program, including pre-registration & customer service/member education functions. Eligibility Unit, including completion of pre-appointment eligibility verification for inpatient & outpatient services and responsibility for resolving related work queues.


Essential Functions:

- Strategic Planning, Influence and Alignment: Contributes to the strategic vision, process improvement plan and implementation strategy for a regional revenue cycle business model, including: pre-registration.
- Eligibility verification.
- Financial counseling and charity care administration.
- Cost share collection.
- Accurate and efficient charge capture.
- Data quality monitoring, auditing and root-cause based feedback mechanisms; and training.
- Provides day to day support in the development and execution of strategic vision and supporting initiatives as agreed to with the Directors of Billing Services and the Director of Eligibility and Financial Support Services.
- Works in support of the Front Office Operations Initiative (FOOI) team on compliant point-of-service registrations and revenue capture internal controls. Contributes input and data as needed to support the aforementioned directors in developing short and long-range financial plans, revenue cycle improvement plans, budgets, capital plans and business plan for the Region.
- Management and Team Building: Provides day to day operational and tactical management of staff and processes in the development of a Regional Revenue Cycle business unit in order to enhance patient experience and ensure sustainability of revenue cycle processes, including but not limited to:
- Securing all technical and system resources.
- Local business office work migration.
- All other activities associated with creating robust, high-functioning regional business units.
- Responsible for hiring, coaching, development, discipline and termination of staff as necessary. Develops subordinates and establishes a climate for personal growth and development. Identifies education and training requirements and works with leadership to develop effective training programs for immediate subordinates as well as their staff.
- Leadership and Consultative Experience: Serves as part of an internal consulting team regarding patient access issues including:  

- All regulatory and compliance requirements.
- Statements of financial responsibility.
- Cost share collection.
- Patient privacy.
- Medical financial assistance.
- This job description is not all encompassing.

Basic Qualifications:
Experience
- Minimum five (5) years in a revenue cycle role including experience with integrated healthcare delivery systems and multi-facility health systems.
- Minimum of three (3) years of experience managing revenue cycle activities for hospital and/or large medical groups with a successful track record in process improvement, improved collections and meeting revenue cycle goals and benchmarks.
Education
- Bachelor's degree in business administration, finance, accounting, health administration or related field OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A
 
Additional Requirements:
- Experience managing activities that lead to measurable and sustainable improvements in any of the following areas: Bad Debt Reduction, Business Office Billing and Collections Operations, Charge Description Master, Charge Capture, Denials Management, Clinical Documentation and/or Patient Admitting/Registration.
- Experience contributing to the development and maintenance of budget and operating plan for revenue cycle operations.
- Hospital/Professional based Coding and Billing experience.
- Demonstrated experience in patient financial services information systems, operations improvement and re-engineering and project management.


- Excellent working knowledge of revenue cycle operations and insurance benefit and product development.
- Excellent communication skills (written and verbal) with the ability to manage both through direct reporting relationships as well as through influence and collaboration.
- Possess the ability to analyze trends, develop and maintain performance goals and regularly provide information to senior management.
- Skilled in coaching, counseling and developing others to achieve operational objectives including teaching the fundamentals of revenue cycle operations and objectives.
- Skilled in team building, team participation and achieving organizational success.
- Possess advanced proficiency in all Microsoft computer applications (i.e., Excel, PowerPoint and Access) and other job-related networks and software.
- Possess extensive knowledge of general business concepts including financial management, organizational behavior and personnel/labor laws and regulations.
- Must be able to work in a Labor/Management Partnership environment.


 


Preferred Qualifications:
- N/A

Primary Location: California,City of Industry,Crossroads Occupational Medicine 12801 Crossroads Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 6:00 AM Working Hours End: 2:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Manager with Direct Reports Job Category: Accounting, Finance and Actuarial Services Department: Occupational Medicine Travel: Yes, 15 % of the Time

About Accounting, Finance, & Actuarial Careers

Accounting Careers

Members of our accounting team support corporate projects and lend insight to areas such as financial reporting, tax planning and preparation, and audit management. This team also includes our audit professionals, who partner with financial and operational groups across the organization to analyze budgets and streamline procedures.

Finance Careers

Supporting critical business functions such as financial services, national Medicare finance, strategic planning, auditing, and corporate finance, our finance professionals develop the strategies that enable us to meet our financial goals.

Actuarial Careers

Applying probability and statistics to the practical problems of insurance, our actuarial team performs a variety of duties, including calculating the cost of premiums and policy values, preparing statistical studies, and forecasting financial results.

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