Mgr Denial Prevention / PA Administration

Denial Prevention And Resolution Manager

Work where every moment matters.

Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common : pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.

With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Position Summary

Responsible for denial prevention and resolution. Requires strong communication and presentation skills. Facilitates coordination between and among revenue cycle departments and clinical departments to prevent and appeal 3

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party denials. Provide oversight and direction to Denials Prevention Team. Partner with representatives and subject matter experts leveraging resources to cultivate standard work and process improvements across the organization. Develop plan to communicate, implement, drive and support operational and cultural changes. Create and deliver monthly / quarterly reports for HHC Revenue Cycle AVP, stakeholders and executive leadership.

Position Responsibilities

Key areas of responsibility

1. Identify trends in Denials data through analysis and consultation with Denials Prevention Team. Provide day to day direction to and help coach Analysts. Relay focus areas to Revenue Cycle VP and AVP and discuss priorities, risks, and next steps.

2. Coordinate material for and provide updates pertaining to the key Denials Prevention Program documentation (e.g. Issues Logs, Monthly Report outs)

3. Partner with the Solution Team Leaders to discuss issue-specific resolution approach. Supporting documentation may include :

Process flows illustrating breakdowns, changes

Sampling results and examples to support the need for changes

Meeting agendas for Solution Team Meetings

Communication plans

4. Create plan for and drive the rollout of changes by coordinating meetings, building consensus for next steps, and holding leadership accountable to issue resolution

5. Manage the implementation and testing of ongoing denials-related technical updates.

6. Direct priorities and own communication regarding the initiative to parties involved in the program (Solution Team Members, Solution Team Leaders). Escalate proposals and required next steps in instances where support is necessary to achieve initiative objectives

7. Develop materials for monthly or quarterly progress updates for the executive leadership team. Support Revenue Cycle VP in presentations and communication to the executives.

8. Perform deep-dive research to back-up work of the Analysts where necessary and appropriate.

Working Relationship

This Job Reports To (Job Title) : Senior Director Strategic Initiatives & Support Services

# Workers Responsible For : 3 Direct Reports

Nature of Supervision : New position will start as an individual contributor with potential to grow team.

Internal : Hospital and operational staff and providers.

External : Payers, Auditors, Government Agencies, Patients.

Qualifications

Education

Minimum : Bachelor's degree in Healthcare Management, Business Administration, or related field. Extensive experience may substitute for education.

Preferred : Master's Degree in Healthcare Management, Business Administration, or related field. Extensive experience may substitute for education.

Experience

Minimum : Two(2) to three (3) years' progressive experience in Healthcare Management in a Revenue Cycle or Financial leadership or influence role

Preferred : Five (5) to Seven (7) years' progressive experience in Healthcare Management in a Revenue Cycle or Financial leadership or influence role.

Knowledge, Skills and Ability Requirements :

Ability to read and understand oral and written instructions, and effectively communicate information. Basic computer skills (including opening / reading email, basic internet use). Expert at managing Revenue Cycle workflow to assure optimum results. Ability to influence and manage large and diverse work groups to assure cohesive interactions to maximize achievement at meeting department and Organizational Goals.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure work / life balance. Every moment matters. And this is your moment.