Kaiser Permanente Manager Revenue Cycle, Billing in Oakland, California
The Revenue Cycle Manager is a management position responsible for the operational success of a revenue cycle business unit. This position is responsible for day to day planning, directing and managing the billing operations, supporting Kaiser Permanente-s ability to enhance patient-s experience and ensure the sustainability of revenue cycle. The Revenue Cycle Manager is responsible for leadership and management of Billing Operations, including daily management and oversight of billing inventory to assist in cycle time within defined parameters.
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.
Qualifications: Basic Qualifications: Experience - 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. Education - 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.
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) Comprehensive knowledge of laws, rules, regulations, procedures and departmental policies relating to EDI, billing and reimbursement from Medi-Cal, Medicare and other public and private medical/financial assistance programs; basic principles of hospital administration.
Prior experience billing from Epic HIS
COMPANY Kaiser PermanenteTITLE Manager Revenue Cycle, BillingLOCATION Oakland, CAREQNUMBER 550412
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, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.