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AVP Patient Access - Telecommute In CA, NV, Or AZ

Expired Job

Unitedhealth Group Inc. Rancho Cordova , CA 95741

Posted 4 months ago

The Associate Vice President (AVP) is directly responsible for providing system level leadership and oversight to Optum360 Patient Registration and Financial Clearance functions, focusing primarily upon delivery of quality service. The AVP will work to leverage performance in Optum360 Patient Registration and Financial Clearance functions, providing feedback and influence to continually improve client, patient, physician, and employee satisfaction levels. The AVP is a critical member of the Optum360 Client Delivery Assurance leadership team, and leads the Optum360 Patient Registration Service Area leadership team and Financial Clearance teams with direct accountability for the Regional Patient Registration Directors and indirect contact with the regional Customer Service Executives (CSEs) and the Chief Financial Officers (CFOs), as well as Financial Clearance Directors / Managers and indirect responsibilities (i.e., standards and performance management) for onsite Patient Intake, Financial Clearance and Financial Counseling staffs. The position has frequent contact with the Regional Patient Registration Directors and the facility Patient Registration Directors, as well as with regional Customer Service Executives (CSEs) and the Chief Financial Officers (CFOs).

The AVP drives continuous improvements in the timely and accurate capture of patient information, facilitating seamless patient flow, proper and timely billing and reimbursement, and maximizing collections at the point of service. The AVP drives a patient-focused culture with an emphasis on accountability and customer service. The AVP utilizes historic and current data to monitor and track performance and trends, and escalates issues in order to improve business and advance Service Level Agreement commitments.

If you are located in CA, NV, or AZ, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Provides system level oversight for the development of processes and initiatives designed to improve Revenue Cycle performance in the areas of:

  • Registration

  • Customer Service

  • Patient Intake (Including but not limited to: Patient Scheduling, Medical Necessity Review, and Medical Orders Management)

  • Pre-Service Screening (Pre-Registration, Insurance Eligibility / Benefit Verification, Pre-Certification / Authorization, Patient Liability Estimation, Pre-Service Collections and Financial Counseling Referral)

  • Financial Counseling (Pre-Service / POS Financial Counseling and Patient Navigation)

  • Revenue Optimization (POS Collections Improvement, Disputed Claims Reduction, Pre-Bill Holds / DNFB Reduction; Payer Provider Collaboration; Compliance Integrity; and Vendor Relations)

  • Physician Liaison (Related to Patient Scheduling, Financial Clearance and Denial Management activities)

  • Other duties as assigned by the local client,

  • Provides system level oversight for Optum360 client improvement programs and initiatives: to ensure clinical and patient experience compliance, drives increase in POS collections, reduction in DNFB, reduction in mail returns, reduction in avoidable write-offs, increase in financial clearance rates, and other initiatives designed to improve financial and customer services outcomes

  • Effectively leads Quality Assurance activities; oversees the utilization of tools to capture data; studies data and develops new processes to continually improve quality

  • Effectively utilizes tools and data provided to capture and continually improve client and patient satisfaction and employee engagement

  • Leads by example; promotes teamwork by fostering a positive, transparent and focused working environment which achieves maximum results

  • Cultivates exceptional relationships at the system level, including building partnerships with client leadership and union representatives, as well as among assigned Regional Patient Registration Directors, resulting in support and participation in initiatives which advance business objectives

  • Participates actively in leadership forums at the system level, and leads such forums and other informational/educational offerings for assigned Regional Patient Registration Directors, Managers and other Patient Access leadership in regards to Financial Clearance activities

  • Maintains and demonstrates expert knowledge of the application of Patient Registration and Financial Clearance processes and best practices; drives the integration of Optum360 Patient Registration, Scheduling, and Financial Clearance related business objectives within the client environment

  • Assists in identifying & building consensus for facilitation of system and process standardization, utilization of best practices, work integration, change management, issue resolution, metric development and measurement, and communication related to the key components of Patient Access operations:

  • Manages the work of department staff, outside consultants, and other Optum360 staff, when used; Note: This may include direct reports and matrix relationships, as well as staff in both centralized and virtual locations

  • Drives the integration of the Optum360 Patient Registration and Financial Clearance functions and processes in the client patient care and business environment

  • Leverages Optum360 and client relationships to gain support and participation in strategies and initiatives and to drive repeatable processes across facilities, creating economies of scale and improving overall performance

  • Identifies opportunities to leverage systems, processes, standardization, or other vehicles to lower cost while maintaining or improving customer service

  • Facilitates planning across Optum360, in coordination with other Optum360 leadership, for the initiative and numerous process improvements needed, including prioritization and implementation in collaboration with other key stakeholders

  • Develops and recommends to Senior Management appropriate processes, policies and structures to govern the organization's Patient Access operations and ensure data security and integrity in compliance with federal and state regulations, including HIPAA. In addition, policies and procedures for acquiring, implementing and using information services in alignment with processes and resources

  • Develops change management strategy to support the transformation of Patient Access operations

  • Oversees detailed work plans to ensure high quality deliverables and adherence to timeframes and budget

  • Analyzes and updates all current Patient Access policies and procedures to ensure standardization and compliance

  • Provides input and direction into strategic plans, goals, objectives, and budgets as impacted by revenue cycle activities

  • Details implementation plans on a fiscal year basis to improve Patient Access activities, and to build and maintain the departmental budget

  • Presents recommendations to Vice-President and Patient Access leadership to be included in Optum360's strategic plans

  • Develops and monitors performance scorecards to measure process outcomes, and to ensure continual process improvements, as required; Ensures all activities are supportive of internal audits, as well as external regulatory requirements

  • Acts as the Patient Access representative related to the design and implementation of all Patient Access processes within the assigned client:

  • Directly involved in any/all decisions related to Patient Access design and process flows

  • Oversees, either directly or through a direct report, discussions related to the development of policies and procedures that will govern Patient Access technology systems

  • May lead a multi-disciplinary team to create the "Best Practice" related to operational process flow

  • Implements and directs strategic and operational initiatives to improve service outcomes (i.e., reduce receivables levels, improve customer and associate satisfaction, etc.)

  • Analyzes current Patient Access activities for efficiency and effectiveness

  • Reviews recommendations to determine implementation value, as well as develops own recommendations, and business case (Return on Investment)

  • Coordinates with various stakeholders to determine the feasibility of performing components of the Patient Access function, including Registration, Financial Clearance, and Financial Counseling activities under different structures and scenarios

  • Develops and utilizes receivables management monitoring and reporting techniques and systems:

  • Researches and recommends leading industry mechanisms for gathering, validating, and storing patient information, and communicating results

  • Ensures effective reporting mechanisms are in place within each department to provide required information

  • Develops and monitors performance scorecard to measure process outcomes, and to ensure continual process improvements, as required; Ensures all activities are supportive of internal audits, as well as external regulatory requirements

  • Proactively monitors performance against Service Level Agreement commitments; takes appropriate and timely action to escalate risks, issues, and drive resolution

  • Monitors exception reports of each department

  • Discusses exceptions with departmental Managers and jointly develops plans to remedy issues identified

  • Ensures that corrective action is taken based upon results of monitoring activities

  • Promotes a service-oriented culture within the organization and assures satisfaction with the quality and amount of support provided for departmental functions, initiatives and projects:

  • Maintains effective levels of communication between key business and clinical stakeholders for all aspects of services being provided by Patient Access, including Financial Clarence operations

  • Maintains professional attitude and ability to relate well with executive management, physicians, other care providers, patients, and others in the hospital community

  • Proactively identifies process improvements required to improve service and implements solutions

  • Assesses and responds to current and future internal and external healthcare trends in order to establish and ensure the necessary direction for Patient Access, Financial Counseling, and Financial Clearance activities

  • Continually seeks ways and means for improving the delivery and support of Patient Access activities and programs

  • Assures that all departmental systems incorporate the principles of total and continuous quality improvement while exceeding the expectations of the customers

  • Assures satisfaction among customer groups with the quality and amount of support provided by monitoring and responding appropriately to outcomes and feedback

  • Understands the job functions of all revenue cycle staff; is aware of process flow across other departments, and involves them, as appropriate, when recommended actions may impact their work functions

  • Maintains positive vendor / outsourced partners relationships:

  • Maintains effective working relationships with vendors regarding pricing and performance concerns

  • Works with vendors to develop mutual opportunities in improving Optum360's services and/or financial outcomes in relationship to revenue cycle operations

  • Works with other Patient Access leaders to negotiate effective service provider contractual relationships to provide quality services and accommodate changing business priorities

  • Establishes governance principles in dealing with technology suppliers concerning ongoing performance issues and disputes

  • 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 for personal and professional development

  • Demonstrates the competencies necessary to influence others' behaviors toward a common dedication to Optum360's mission, goals, and objectives

  • Participates in local, regional and national health care revenue activities and professionally represents Optum360 at these functions

  • Serves in a leadership role and promotes positive Human Resource Management skills:

  • Fosters teamwork atmosphere between business and clinical stakeholders

  • Hires and manages staff to achieve strategic objectives

  • Provides staff training and mentoring

  • Maintains close business relationship with associates at the regional and local levels by ensuring onsite presence at regular intervals and during special events

  • Other duties as needed and assigned by the Vice-President, Patient Access or other Optum360 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-departmental resources, as required

  • Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Optum360's organizational integrity program, 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

Required Qualifications:

  • 10 years in supervisory / management role in an Acute Care Facility/Acute Care Health System

  • Bachelor's Degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field required

  • Proficiency with Microsoft Excel, Word, and PowerPoint

  • Prior experience with the major Patient Access technologies currently in use, and/or other "like" systems

Preferred Qualifications:

  • Master's Degree

  • 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

  • Extensive Contact Center / CRM / Telephony experience in Patient Scheduling and/or Patient Access-related activities

  • Certification within Healthcare Financial Management Association (HFMA) and/or the National Association of Healthcare Access Management (NAHAM)

  • Experience leading or participating in large Patient Access-related IT and/or Contact Center program implementation

  • Proficiency with Microsoft SharePoint and Project

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)

  • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

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AVP Patient Access - Telecommute In CA, NV, Or AZ

Expired Job

Unitedhealth Group Inc.