Manager, Revenue Cycle (RN)

Mercy Medical Center

 
This position supports Mercy's philosophy of patient centered care by ensuring understanding of rules and regulations issued by CMS, Medicaid, and payers.  Also provides education to the overall system.
 
Job Duties/Essential Functions
 
Leadership Competencies
 
Leading
  • Formulates a future course that reflects departmental needs and is aligned with Mercy's vision. Translates the course into team goals and objectives, sets priorities, and directs the efforts of staff towards accomplishing them.
  • Recognizes and acts on opportunities for growth and improvement to advance Mercy's goals.
  • Inspires staff enthusiasm for and generates commitment to departmental and organizational goals.
Standards and Accountability
  • Holds team and self responsible for maintaining the highest possible performance standards and meeting agreed upon commitments.
  • Sets and maintains high standards for service to patients, physicians, colleagues, and other Mercy departments. Incorporates needs and concerns of diverse constituencies into decision making.
Planning and Decision Making
  • Analyzes problems systematically and logically and is resourceful when developing and implementing solutions.
  • Applies key financial concepts and analysis to decision making. Understands drivers of financial performance and takes these into account when developing strategies and making decisions.
  • Develops and implements work plans with actionable components and measurable outcomes. Proactively monitors key performance indicators and makes real-time adjustments to ensure that progress stays on track.
  • Regularly reassesses priorities and competing demands and adjusts allocation of own and staff time and resources to increase efficiency and effectiveness.
Communication
  • Articulates logical and well-founded arguments that support conclusions. Matches communication style to the message and audience. Actively solicits opinions from others. Routinely provides others with the information they need to do their jobs.
  • Routinely shares suggestions, advice, and insights on progress toward goals. Provides performance feedback that is constructive and actionable, and that highlights successes as well as areas for growth based on objective metrics.
Developing People
  • Selects and attracts outstanding staff from diverse backgrounds. Identifies and fills gaps in team skills and knowledge.
  • Defines development objectives for self and staff that support performance goals and progress toward future skill development. Assists staff in developing their own careers by encouraging them to articulate their career goals, offering challenging growth opportunities, and providing necessary coaching and training.
Managing Relationships
  • Builds and maintains long-term relationships with others based on mutual respect and trust. Fosters cooperation and collaborative decision-making among staff with diverse backgrounds and interests. When conflict arises, works effectively towards solutions and compromises that take the needs of all parties into account.
  • Provides regular updates on goal progress and works with own manager to minimize risks and resolve problems.
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Job Duties
  • Identifies future needs, new technologies and products for applicability to the department and makes recommendations as appropriate.
  • Recommends the integration/utilization of existing systems in conjunction with Technology Services.
  • Manages staffing levels, schedules, employee relations, employee discipline, and performance evaluations.
  • Inputs and monitors Laborworkx administration of employee's time and attendance, staff scheduling, education, and labor productivity.
  • Monitors and evaluates programs for operational effectiveness, and makes required changes for continuous improvement.
  • Provides input to administration regarding the feasibility and cost justifications for customer requests, and analyzes a number of alternative solutions.
  • Reviews monthly invoices and consults with vendors to provide the most efficient means of communication and departmental operations.
  • Establishes and implements short and long term departmental goals, objectives, strategic plans, policies and operating procedures within financial guidelines.
  • Plans and develops the annual capital equipment budget to ensure that departmental services are adequately planned for and provided.
  • Prepares or provides input to preliminary Capital, FTE and operating budgets for MMC business services departments by due date. Meets approved operating expense budget or accounts for any variances with revisions identified for fiscal year.
  • Supervises the quality and training programs.
  • Creates a culture of interdisciplinary and interdepartmental cooperation and communication by motivating staff to continuously improve performance.
  • Provides for mechanisms to measure, analyze and manage variation in the performance of defined processes.
  • Provides guidance with development, implementation, and maintenance of the department and organization's information privacy policies and procedures.
  • Evaluates productivity measures annually and adjusts standards to optimize effectiveness and efficiency within own department and organization-wide.
  • Leads by providing feedback and direction to other segments involved in the revenue cycle.
  • Conducts regular staff meetings to communicate departmental/enterprise issues.
  • Develops and maintains accurate job descriptions and performance standards for all job classifications.
  • Develops and lead interactive discussions/education related to RAC compliance and associated process improvement.
  • Leads the RAC Steering Committee.
  • Conducts oversight of all RAC functions including development and coordination of an internal tracking system for record requests using an automated system.
  • Develops internal training programs for all providers and staff.
  • Maintains open communication between the RAC team and Administration.
  • Leads the continuous improvement and accreditation (Quality) and financial services, care coordination, and RACs/CMS.
  • Coordinates all activities associated with RAC requests and appeals including management of the handoff of records between departments.
  • Assists HIM in invoicing record requests and communicate with all affected external entities involved in the RAC process.
  • Audits all RAC findings following all RAC activity to closure and coordinate these findings with reports to corporate compliance.
  • As the subject matter expert you will assists with clinical reviews/internal audits.
  • Leads all CDMIP activity, reporting, educating, and dashboarding.
  • Understands payer utilization management rules, authorization guidelines, and all associated forms and lines of communication that must be maintained.

Knowledge, Skills and Abilities

  • Proficient in Microsoft Office products.
  • Proficient in operation of computer, calculator, filing systems, copy/fax machines and telephone system.
  • Excellent interpersonal skills.
  • Excellent written and verbal communication skills.
  • Excellent public relations and human relations - exemplifies The Mercy Touch.
  • Excellent organizational and time management skills.
  • Critical thinking and attention to detail.
  • Exhibits good judgement.
  • Handles confidential information with discretion and diplomacy.
  • Commitment to life-long learning, e.g. willingness to learn/upgrade skills related to duties.
  • Flexibility and dependability, works well with a wide variety of individuals and leadership styles.
  • Ability to work with minimal to no supervision.
Professional Experience
  • Minimum five years clinical, Utilization Managment, or Recovery Audit Contractors/CDMIP experience required.
Education
  • RN required
  • BSN preferred
Licensure, Certification, Registration
  • Maintain current Registered Nurse licensure in the State of IA required
  • CCDS preferred

Location: Mercy Medical Center - Cedar Rapids · Health Information Management
Schedule: Full Time, Day, 8 to 4:30 M-F with occasional need for staff that work evening or weekend

Job ID: 81461

Posted 26 days ago

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