The Manager of Financial Clearance is responsible for effectively leading and directing the work of assigned staff within the parameters of designated performance standards and metrics. The manager is expected to motivate staff to achieve the highest levels of customer satisfaction and to meet the organization goals for customer service and financial performance. The Manager interacts with other departments within the Optum360 Patient Contact Center as well as within assigned client sites, as required and serves as a representative of the corporate Patient Access Revenue Cycle Operations department. The incumbent attends managerial meetings as required and supports the core values of Optum360, which is an integral part of this position. Although this position is primarily focused upon the provision of service at the Optum360 Patient Contact Center, the position has frequent contact with the Regional Patient Registration Directors and the facility Patient Registration Directors. Primary Responsibilities:Provides system level oversight for the development of processes and initiatives designed to improve Revenue Cycle performance in assigned areas which includes: Serving as the liaison between the Patient Access Contact Center and Facility-based Patient Registration activities, working with Patient Access leadership to ensure process standardization, optimization and integration Responsibility for issue resolution, including but not limited to data collection, root cause analysis, reporting, mitigation action plans, and communication / follow-up related to the standardization of Patient Access activities with emphasis on Financial Clearance (Pre & Post), Upfront Collection, and Financial Counseling Development and roll-out of related policies/procedures, strategy, communications, and other management components in coordination with Regional and Facility Directors Oversight of reoccurring monthly and ad hoc meetings to inter/intra-departmentally coordinate Patient Access activities Researching and communicating payer information, including Health Insurance Exchange (HIX), Hospital Presumptive Eligibility (HPE) and other payer trends and activities Other duties as assigned Provides system level oversight for Optum360 client improvement programs and initiatives related to assigned Patient Access activities, working with the department's Senior Directors, Regional Patient Registration Directors, Facility Directors, Corporate Directors and Managers, as warranted. Effectively participates in sectional Quality Assurance, Patient Satisfaction, Employee Engagement and Process Improvement activities; ensuring associate understanding and commitment, as well as expected process improvement outcomes. Leads by example: promotes teamwork and operational relationships by fostering a positive, transparent and focused working environment which achieves maximum results. Maintains and demonstrates expert knowledge of the application of Patient Access processes and best practices; drives the integration of Optum360 Patient Access related business objectives within the client environment. Knows, understands, incorporates, and demonstrates the Optum360 Mission, Vision, and Values in behaviors, practices, and decisions. Serves in a leadership role and promotes positive Human Resource Management skills: Interviews, selects and is accountable for the on-going development and evaluation of individuals within the area of responsibilityDevelops associate loyalty and retention through effective associate engagement, inclusion and participation; Proactively solicits, listens to and addresses associate suggestions; Promotes a professional environment that recognizes and respects diversity Develops associate work schedules to ensure cost effective staffing that meets customer requirements, while promoting an economical, efficient workforce and considers associate work-life balance Establishes, implements and evaluates on-going performance improvement programs, utilizing an interdisciplinary approach; Escalates to the Senior Director any unfavorable trends or disciplinary actions; Provides managerial follow-up related to performance, up to and including disciplinary actions and termination Provides staff training and mentoring to promote growth and development of assigned resources Responsible for the financial and personnel management of assigned areasProvides leadership for departmental services through collaboration with customers, employees, physicians, clinics, other Optum360 / client departments and services, vendors, etc. Scope of job duties, include and are not limited to: Directly responsible for effectively managing the assigned Patient Access activities and staff members. Demonstrated ability to interpret 3rd party payer contract requirements and recommend, design and implement procedures for compliance with regulations and standards Uses knowledge of Patient Access industry leading practices, performance metrics and monitors, and other documentation in order to expedite appropriate use of resources and ensure 3rd party payor and client compliance Responsible for distributing process updates regarding criteria changes, regulation changes, process and program changes to assigned staff, ensuring their understanding and future complianceManages assigned staff in order to ensure steady workflow balance and high quality outcomes: Effectively directs and facilitates a multidisciplinary team to achieve its desired outcome Creates a culture supportive of personnel, fostering individual motivation, teamwork and high levels of performance and accountability, and staff retention Supports a collaborative, participative management style Fosters teamwork atmosphere between business and clinical stakeholders Maintains close business relationship with associates at the regional and local levels by ensuring onsite and virtual presence at regular intervals and during special events Educates physicians, physician office staff, and organizational associates regarding assigned Patient Access requirements: Functions as a consultant to Regional and facility-based Patient Registration Directors, physicians, case managers and others regarding assigned performance guidelines and standards for Patient Access services Meets with individual or groups of physicians, family members, 3rd party payers, and vendors as necessary in order to facilitate the Patient Access processIdentifies action plans to improve the quality of services in a cost efficient manner and facilitates plan implementation. Prepares required reports using statistically sound information, displaying content in easily understandable format; Escalates to the Corporate Leadership any unfavorable trends. Maintains professional development and growth through journals, professional affiliations, seminars, and workshops to keep abreast of trends in revenue cycle operations and healthcare in general: Participates as appropriate in continuing educational programs and activities that pertain to healthcare and revenue cycle management, as well as specific functional areas Develops and implements an annual plan of personal and professional development Demonstrates the competencies necessary to influence others' behaviors toward a common dedication to the Optum360's mission, goals, and objectives Participates in local, regional and national health care revenue activities and professionally represents Optum360 at these functionsOther duties as needed and assigned by the Corporate Leadership or in coordination with other Optum360 Patient Access or Revenue Cycle Leadership, including but not limited to leading and conducting special projects. Develops project work plans, facilitates resource allocation, executes project tasks and obtains assistance from other intra and inter-functional resources, as required. Maintains a working knowledge of applicable federal, state, and local laws and regulations, Optum360's Compliance, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior Professional develop of the team, assist in growing careers of team members
Required Qualifications:Bachelor's Degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field required OR 10 years of substantial experience and career growth in Revenue Cycle leadership role may substitute for educational requirement 10+ years in supervisory / management role Proficient with Microsoft Excel, Word, Project, PowerPoint and SharePoint Prior experience with the major Patient Access technologies currently in use, and/or other like systems Demonstrated client service orientation Strong program management skills with the ability to lead and manage multiple, concurrent running projects, prioritize tasks and adapt to frequent changes in departmental priorities Ability to recognize necessary changes in priority of tasks and allocation of resources, and bring them to the attention of Optum360 leadership, as required Demonstrated knowledge of process improvement techniques are essential to success, as is the ability to be a self-starter and work independently to move projects successfully forward Ability to work with a variety of individuals in executive, managerial and staff level positions (the incumbent frequently interacts with staff at the Corporate/National, Regional and Local organizations; may also interact with external parties, such as financial auditors, third party payer auditors, consultants, and various hospital associations) Must be comfortable operating in a collaborative, shared leadership environment that encourages change engagement and participation, and open dialogue Ability to work within the organization at all levels utilizing a very "hands-on" approach to creating value and buy-ins as the lead change facilitator Ability to attract, develop, deploy and retain a world class revenue cycle team, capable of performing as a team and of evolving with the organization's vision and with cutting edge technologies Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Optum360 and our client organization(s) Demonstrated ability to interpret 3rd party payer contract requirements and recommend, design and implement procedures for compliance with regulations and standards Ability to negotiate with insurance vendors, medical directors, and 3rd party payers when appropriate in order to facilitate the delivery of care in the most appropriate setting Operational knowledge of Federal and State regulations pertaining to patient admissions, as well as standards from regulatory agencies and accrediting organizations (DHS, HCFA, OSHA, TJC) Travel 25% on the timePreferred Qualifications:Acute Care Facility Patient Access Department leadership experience, managing one or more functional areas of: Patient Scheduling, Pre-Service/Financial Clearance, Registration, Financial Counseling, or other management functions related to revenue cycle activities in a complex, multi-site environment 5+ years of consulting and project management experience in revenue cycle design and optimization Certification within Healthcare Financial Management Association (HFMA) and/or the National Association of Healthcare Access Management (NAHAM) Master's Degree Experience leading or participating in large Patient Access-related IT and/or Contact Center program implementation Cerner Millennium, MS4, Invision, Mede/Analytics PACareers 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: patient access, financial clearance, insurance verification, authorization, call center, service center, Dignity, patient liability, patient financial services, Optum360, pre-service, Phoenix, AZ
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.