No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm) A CSE is the lead driver for relationship management and executive communication in Optum360 outsourced end to end revenue cycle clients. The CSE applies knowledge and expertise of acute care revenue cycle areas that include Patient Registration, Health Information Management, Clinical Documentation Improvement and Patient Financial Services to oversee successful delivery of services and execution against Service Level Agreement Targets. The CSE is the primary point of contact for client hospital executives including Hospital Presidents, Chief Financial Officers, Care Coordinators, and Chief Medical Officers. In this capacity, the CSE focuses on client satisfaction, executing solutions as promised, demonstrating and maximizing ROI for the client, revenue retention, and uncovering opportunities for growth. The CSE is the 'voice of the client' and is responsible for addressing client concerns with Optum360 operations in revenue cycle areas that include Patient Registration, Health Information Management, Clinical Documentation Improvement and Patient Financial Services. As the escalation point on behalf of the client, the CSE ensures inquiries are responded to and resolved in a timely fashion, Optum360 commitments are delivered, client business metrics are measured and maintained at agreed upon levels. CSEs maintain assigned clients with a high - level of autonomy and self - sufficiency. Long term relationships with hospital executives are built and maintained. Communication is critically important, as such; CSE's hold periodic meetings with hospital executives to report progress. Meetings include, but are not limited to Revenue Cycle, Denials, Presidents Briefing, and CFO Updates. CSE's are analytic thinkers with deep understanding of the revenue cycle in the acute care setting. As part of the Optum360 commitment to communication, the CSE receives standard and custom reports that reflect trends and overall state of client operations. CSE's review, interprets, summarize and share vital data with client executives on a regular basis. Primary Responsibilities:Establish effective relationships with acute care client executives to understand their objectives, business drivers, and success measures. Responsible for relationships and Interaction with executives in roles that include Hospital Presidents, Chief Financial Officers, Care Coordinators, and Chief Medical Officers Act as a client advocate when addressing and resolving client concerns with Optum 360 operational owners in the following areas Patient Registration, Health Information Management, Clinical Documentation Improvement and Patient Financial Services Understand, monitor and report negative trends in client critical business metrics including, but not limited to Point of Service Cash Collection, Pre Service Insurance Resolution Rate, Discharged Not Final Bill Quantities, Case Mix Index, CDI Query Response and Agreement Rate, Billing Edits / Backlogs, AR Aging, Cash Collection, Bad Debt, Credit Balances and Denial Rates Maintain regular meeting cadence with hospital executives. Responsibilities include but are not limited to meeting schedule, attendee list (both client and Optum360), preparation, execution and follow - up. Meetings include but are not limited to Monthly Revenue Cycle, Monthly Denials, Presidents Briefings, CFO Updates and Annual Service Area Updates Review interpret, summarize and distribute routine reports to hospital executives including but not limited to Discharge Not Final Billed, AR Detail, Cash Analysis, Denial Trends, Payment Variance Develop annual Client Plans detailing the client's goals and objectives and alignment with Optum360's products and services Coordinate client change order process when Optum360 revenue cycle services are identified and not provided Maintain focus and engagement with clients on semi - annual Client Satisfaction Survey, including Optum360's Net Promoter Score (NPS®). This includes creating individual plans to address satisfaction issues within survey respondents Understand payer dynamics and the challenges that exist with efficient resolution of Accounts Receivable (e.g., Initial Denials, Clinical Appeals) Leverage Optum360 resources (e.g., Facility Business Office Liaison, Revenue Cycle Optimization, Payer - Provider Collaboration Team) to meet client business challenges Assist in managing clients to internal profitability goals Proactively managing and communicating current operational results and transformation projects status to hospital executives Maintain regular meetings with hospital executives to review performance, client's business needs and Optum360 solutions Monitor all revenue cycle operations through management report interpretation, summarize and distribution to hospital executives Consult with hospital personnel and internal teams to ensure they utilize Optum360 solutions to their greatest potential, understand all of the benefits, are maximizing the ROI Ensure high client satisfaction and improving NPS scores Increase client satisfaction, streamlining workflows and / or reduce internal expense Coordinate with Optum360 Operations teams in preparing and executing detailed performance recovery plans for hospitals not meeting AR Day and / or Cash Collection goals
Required Qualifications:Undergraduate Degree or equivalent experience 10+ years working with senior level C suite executives in the hospital / provider space Operational expertise in acute care hospital departments including Patient Access, Health Information Management, Clinical Document Improvement and Patient Financial Services (billing, collection, cash posting, account follow - up and reconciliation) Familiarity with Hospital Information Management systems including Patient Registration, Patient Management (clinical), Hospital Information Management, Clinical Documentation Improvement, Patient Accounting Professional memberships including HFMA, and or ACHE Strong domain breadth and expertise (health care, revenue cycle, finance etc.) Operations, Implementation, or Program Management.Preferred Qualifications:Advanced degree (i.e.: MBA, MHA) Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Operations, Patient Financial Services, HIM, Patient Registration, Santa Cruz, Modesto, Bakersfield, CA, California
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.