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Kaiser Permanente Careers

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 Revenue Cycle - Admitting

Location: South San Francisco, CA Additional Locations:
Job Number: 825518 Date posted: 09/06/2019

The Revenue Cycle Manager is responsible for planning, directing & managing Patient Financial Advisor (PFA) operations & Admitting functions w/in a medical center. The PFA focus is on handling all financial liabilities associated w/ members' care & the admitting focus is on scheduling & balancing the workload for 24/7 hospital operations, ensuring compliance w/ all regulatory requirements, policies & procedures, including readiness for external surveys &/or audits, & readiness for disaster recovery.

Essential Functions:
- Accountable for an integrated member advocacy strategy, working in partnership w/ Member Services, to enhance the member experience. Coordinates w/ Utilization Review/Utilization Management, Social Services, Patient Care Services & Discharge Planning to facilitate appropriate financial sponsorship, authorization, reporting, & discharge process compliant w/ payer & government regulations. Insures timely & accurate coverage assessment (financial rounding) of all inpatient hospital patients. Ensures adequate Patient Financial Advisor coverage for at risk hospital admissions, emergency room visits & high dollar hospital outpatient services. Works in partnership w/ Regional Charity Care (MFA), Community Benefits teams & Community based organizations. Works w/ patients/members as needed, resolving difficult issues. Accountable for external vendor performance & relationship for services supporting eligibility or linkages to other coverage or payer sources.
- Responsible for the day-to-day operations of a team of Admitting & Patient Financial Advisors support staff. Hires, coaches, develops, & disciplines staff as necessary. Works w/ direct reports to develop tactical & strategic solutions to meet the goals of this position. Helps to foster an environment & culture w/in the Revenue Cycle that is built upon open communication, trust & honesty, & collegiality which complements the Kaiser culture & ensures future success. Recruits, develops, & maintains competent & productive team. Responsible for submission of payroll (TIME) for staff.
- Collaborates various hospital operations, medical centers & regional leads & staff members, as well as external groups to ensure that departmental activities are in compliance w/ internal policies & external laws, standards, as well as confidentiality, information security, safety, environmental/infection control, financial accountability & related hospital operations requirements.
- Monitors performance results through observations, audits, statistical data analysis & operational reports, to achieve & sustain target operational metrics & address deficiencies by developing & implementing action plans, process improvement & employee development.
- Provides consultation & recommend solutions to difficult eligibility & admission problems. Evaluates & improves the delivery of service by initiating & promoting best practice models. Engages clinicians (for example, RN, MD, CNS, or PT), managers & staff in problem solving coverage or financial sponsorship opportunities. Provides education & direction to direct reports & medical center constituents. Identifies opportunities & provides support to assist w/ the implementation of revenue cycle performance improvement actions. Participates in Labor/Management initiatives. Works in partnership w/ registration leaders on data quality improvement opportunities. Monitors the efficiency of the workload & process improvement.
- Responsible for the on-going management of the departmental budget to meet fiscal goals for capital, payroll & non-payroll expenses.

Basic Qualifications:
- Five (5) years of relevant, progressive experience in a management role.
- Three (3) years of concurrent experience in a revenue cycle capacity in an acute hospital environment.
- Bachelor's degree, OR four (4) years of directly related experience in Revenue Cycle.
- High School Diploma OR General Education Diploma required.
License, Certification, Registration
- N/A
Additional Requirements:
- Demonstrated ability to lead multi-disciplinary teams through complex, medical, social and financial conversations.
- Ability to analyze trends, develop and maintain performance goals and regularly provide information to senior management.
- Must be able to demonstrate effective written and verbal communication skills, as well as training and facilitation skills.
- Demonstrated ability to provide superior customer service.
- Ability to manage multiple initiatives, identify and prioritize issues to meet aggressive deadlines and organizational goals.
- Excellent supervisory, problem solving and decision making skills required.
- Experience working with automated mainframe, personal computer and business software applications.
- Proficiency with Microsoft Office (i.e. Excel, Word, PowerPoint).
- Must possess experience managing through direct reporting relationships as well as through influence and collaboration with providers and executives, both inside and outside KP.
- Must have experience developing and maintaining budgets and operating plans.
- Skilled in team building, team participation, and achieving organizational success.
- Skilled in coaching, counseling, and developing others to achieve operational objectives.
- Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:
- Prior experience managing staff in a 24-hour/7-day a week department.
- Certified Health care Financial Professional (CHFP) through the Health care Financial Management Association (HFMA) preferred.

- Working knowledge of revenue cycle including: Insurance coverage, benefits and authorization requirements; Payer specific requirements (e.g. workers' compensation, managed care, commercial insurance, third party liability, Medicare, Medi-Cal, and other government programs)
- Eligibility requirements for special circumstance coverage (e.g. Charity Care, Victims of Crimes, California Children Services);
- Comprehensive knowledge of laws, rules, regulations, procedures and departmental policies relating to admissions and eligibility for reimbursement from Medi-Cal, Medicare and other public and private medical/financial assistance programs including Title 22 of California Administrative Code; basic principles of hospital administration.

Primary Location: California,South San Francisco,S. San Francisco Hospital 1200 El Camino Real Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon - Fri Working Hours Start: 8:00am Working Hours End: 4:30pm 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: Admitting Travel: Yes, 10 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

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 and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

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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