Manager, Provider Network Records

Navihealth Brentwood , TN 37024

Posted 2 months ago

Why navi

Health?

navi

Health is the result of over a decade of dedicated visionary leaders and innovative organizations challenging the status quo for PAC management solutions. We do healthcare differently and we are changing healthcare one patient at a time. How might you ask? By hiring talented clinicians, engineers, analysts, and healthcare leaders to create and utilize cutting edge technology to provide the patient with the best level of care for the right amount of time.

Why Is This Role Critical?

The Manager will be responsible for leading the day-to-day operations of the Network Coordinator team and ownership for record completion across the enterprise. The Network Coordinators are responsible for the accuracy of database documentation and the completeness of the medical record and navi

Health database. Specifically, this role is responsible for operational oversight, ensuring data integrity, strategic planning, policies, well as quality and productivity standards. The Manager, with direction from the Director, oversees delivery of weekly reporting and ensures adequate daily staffing. The Manager may be asked to assist the Director of Network Data in departmental governance including the establishment, maintenance and documentation of departmental policies and procedures and ensures these policies and procedures reflect navi

Health's organizational mission and goals.

What you will be accountable for.

  • Developing and driving execution within the team via clear goal setting, defining success, and managing evolving market and business needs.

  • Directs day-to-day operations at the colleague level, assigning and coaching colleagues as needed, to ensure service level and quality standards are met.

  • Forecasts, aligns resources, and delivers training to new and existing colleagues.

  • Participates in recruitment, interview, and hiring processes.

  • Maintains expert knowledge of: all applicable client process, contractual requirements, databases, compliance, data integrity, and security requirements.

  • Identifying areas of opportunity and ensures execution of department and market process improvement initiatives.

  • Ensuring colleague base is properly trained and is current in ongoing training in all relevant functions of the roles and delivers supplementary and ongoing coaching/training as needed for development.

  • Ensuring all SLAs are being met real-time and escalates issues that may negatively impact SLAs to Director.

  • Developing relationships with key internal customers such as Network Managers, General Managers and other operational leaders.

  • Utilizes weekly dashboards, quarterly reports, and other reports as needed to ensure end user colleagues are meeting expected performance metrics. This includes holding 1:1 performance management sessions with the colleague base.

  • Monitors departmental quality including adherence to navi

Health Record Completion Guidelines.

  • Escalates issues prohibiting or restricting service standards regarding but not limited to technology, service standards, and productivity to Director and appropriate navi

Health resources.

  • Performs all other duties as requested in support of the departmental and organizational goals.

What you will need to be successful

  • Bachelor's Degree in Business Administration, Organizational Development, Finance, Learning, or related field.

  • 35 years healthcare operations or administration experience to include demonstrated leadership preferred.

  • Experience in healthcare setting strongly preferred.

  • Exceptional interpersonal and communication skills.

  • Must be results driven and comfortable working in a fast-paced and dynamic environment with a high degree of accuracy

  • Excellent written and oral communications skills.

  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.

  • Demonstrate critical thinking skills.

  • Creative thinking and problem-solving experience with the ability to consider impacts of decisions or actions.

  • Ability to verbally articulate and communicate with Director, team members, and customers.

  • Extremely detail oriented. Correctly interpret data and information in the nH Coordinate system.

  • Work cross functionally to drive results.

  • Ability to influence stakeholders in a matrixed environment to drive projects to success.

About Us

navi

Health is a pioneer in post-acute care and care transitions with a combined and unprecedented 18 years of experience that uniquely positions us to manage patients, improve clinical and financial outcomes, and share risk with payors and providers. As a Cardinal Health company, we provide clinical support alongside scalable technology and advisory solutions that empower health systems, health plans, and post-acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes.

navi

Health Values

We care about the people we serve.

We care about each other.

We care about our communities.

We embrace innovation.

We like simple.

navi

Health is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Provider Enrollment Specialist Virtual

HCA

Posted 1 week ago

VIEW JOBS 9/7/2018 12:00:00 AM 2018-12-06T00:00 Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized services in the areas of revenue cycle, purchasing, supply chain, technology, workforce management and consulting. Parallon's purpose is simple. We serve and enable those who care for and improve human life in their communities. Provider Enrollment Specialist Job Summary – The Provider Enrollment Specialist is responsible for processing enrollments for new and existing individual providers and group practices, such as initiating new enrollments with Commercial and Governmental payors and reporting demographic or other provider changes. Other duties include follow-up on open applications with providers or payors, including escalation to the Provider Enrollment Account Management team or Strategic Pricing and Analytics (SPA) Managed Care Team for resolution. Supervisor – Provider Enrollment Manager Supervises – None Duties (included but not limited to) * Ensure provider participation with contracted payors by taking appropriate next actions to complete enrollment, such as completing applications, rosters, and notifications * Monitor inventory * Escalate items to other areas outside of department as needed * Work with payors and providers to ensure compliance with enrollment process * Initiate contact with payors and practices via telephone or electronic methods with respect to provider enrollment and billing errors, utilizing proper customer service protocol * Update and maintain data in appropriate Provider Enrollment systems while ensuring accuracy and data integrity * Review correspondence received and perform appropriate action to resolve * Appropriately resolve or escalate payor application denials * Meet and maintain established departmental performance metrics for production and quality * Maintain working knowledge of workflow, systems, and tools used in the department * Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement" * Other duties as assigned Knowledge, Skills, and Abilities * Communication - communicates clearly and concisely, verbally and in writing, utilizing proper punctuation and correct spelling * Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations * Interpersonal skills - able to work effectively with other employees, patients, and external parties * PC skills - demonstrates proficiency in Microsoft Office applications and others as required * Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures, and systems * Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes; able to work quickly and accurately in a fast-paced environment while managing multiple demands; able to work both independently and collaboratively as a team player; demonstrates adaptability, analytical and problem solving skills, and attention to detail; and able to perform basic mathematical calculations, balance and reconcile figures, and transcribe accurately Education High school diploma or GED required Experience Minimum one year related healthcare experience preferred, such as Medicare/Medicaid Enrollment or Managed Care Enrollment. Relevant education may substitute experience requirement. Knowledge of National Plan and Provider Enumeration System (NPPES) and Council for Affordable Quality Healthcare (CAQH) preferred. Provider Enrollment experience preferred. Certificate/License None Physical Demands / Working Conditions– Requires prolonged sitting/standing, some bending, stooping, walking and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports or other information. Requires lifting papers/boxes and pushing/pulling up to 25 pounds occasionally. Work is performed in an office environment or hospital setting. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations. OSHA Category– The normal work routine involves no exposure to blood, body fluids, or tissues (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency care or first aid, or to be potentially exposed in some other way. HCA Brentwood TN

Manager, Provider Network Records

Navihealth