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This position is responsible for operational aspects of the department, in addition to supervising the team members, this position performs the following:
• Use independent judgment to administer all aspects of related personnel policies.
• Plan, direct, and manage the business operations including developing new support service lines and programs. This may also include the oversight of additional functions such as project planning, facilitating meetings, implementation, and change management.
• Must be able to manage to key performance indicators and metrics associated with call center staff and personnel which may include driving service levels, quality outcomes & service, managing production, and staffing appropriately to proactively meet customer service needs. Manages turnaround time on referrals turnaround times.
• Plans, directs and manages major implementations of new equipment, software, and processes.
• Manages effective marketing campaigns & develop relationships with Renown & community referring physician offices for all Engagement Center business.
• Perform continual process improvement using lean methodology. Increase automation and streamline processes to improve customer service satisfaction while increasing efficiencies and managing costs.
• Supervises and/or prepares reports, documents, payroll records, statistical surveys and other data required for departmental administration and for compliance with various licensing and regulatory agencies. Analyze data and create necessary reporting to manage and improve the business.
• Prepares departmental, operational, and capital equipment budgets; is responsible for managing and explaining actual budget fluctuations.
• Is directly involved in short and long range department planning and communication of strategy as well as aligning their teams’ work to the mission and vision of the organization.
• This position is responsible for employee retention, compensation, engagement, and career development.
• This position is to plan, develop and implement department procedures; hire, evaluate, coach and terminate employees.
• This position is responsible for understanding CMS STAR measures & to implement processes, programs and manage performance to support the achievement of these measures.
This position is responsible for developing, improving and maintaining a compliance program that ensures compliance with state and federal regulations, including, but not limited to HIPAA, the Centers for Medicare and Medicaid Services (CMS) and the state of Nevada Division of Insurance.
• This position must be able to communicate with patients, the general public, senior leadership, employees and clinicians.
The Engagement Center is experiencing considerable change requiring the incumbent to keep abreast of the state-of-the-art in technology and best practices. As a manager, the incumbent must be an effective communicator and have the capacity to effectively problem-solve, make appropriate decisions, and produce desired results.
KNOWLEDGE, SKILLS & ABILITIES
• Strong customer service skills with the ability to provide service recovery immediately as needed.
• Working knowledge CMS regulations as they relate to a Medicare Advantage Plan.
• Working knowledge of health insurance.
• Working knowledge of medical billing practices to include, but not limited to medical terminology, CPT, ICD9/10, and HCPCS coding.
• Ability to communicate diplomatically, clearly and concisely, both verbally and in writing.
• Ability to maintain confidentiality of medical and personal information of all customers.
• Ability to ensure all goals and deadlines are met.
• Ability to develop and provide education programs to maintain a competent and efficient staff.
• Ability to analyze and interpret data, control deficiencies and initiate corrective action as needed.
• Demonstrated skills in problem identification, problem solving and process improvement.
• Demonstrated leadership skills to promote individual and team excellence.
• Strong organizational skills.
This position does not provide direct patient care.
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