Department:
Status:
Benefits Eligible:
Hours Per Week:
Schedule Details/Additional Information:
Monday through Friday first shift.
Pay Range
$28.05 - $42.10Major Responsibilities:
- Oversees day-to-day operations designed to complete eligibility assessments with uninsured patients across pre-arrival and point-of-service workstreams. Accountable for meeting productivity standards and KPIs focused on maximizing opportunities to determine program eligibility and initiate the process of applying for Medicaid, other coverage or financial assistance.
- Directly responsible for overseeing the end-to-end processes involved in helping patients apply for and secure Medicaid coverage. Manages and supports teams that operate under the authority to act on the patient’s behalf throughout the Medicaid application process, up to and including representing patients at administrative appeals. Liaises and works closely with internal partners, legal counsel, county and state agencies to ensure compliance and continuity with the Medicaid application process.
- Accountable for meeting KPIs and performance targets focused on maximizing the success of coverage assistance processes, including but not limited to QA and productivity metrics, goals for gross-self-pay charges converted to Medicaid and AR management. Regularly assesses performance metrics to ensure compliance with workflow expectations and departmental policies.
- Manages cross-functional workflows designed to help reduce length-of-stay and achieve other organizational goals and initiatives.
- Oversees marketplace enrollment workflows and ensures Certified Application Counselors (CACs) are in compliance with the set of rules and regulations that must be followed in assisting patients with marketplace enrollment.
- Contribute to building and developing a highly effective team to provide oversight for staffing, performance management and regulatory support.
- Play an active role in the design and continuous improvement of all processes that ensure accounts are managed promptly and effectively to secure Medicaid or other coverage. Demonstrate accountability through contributing to continuous quality improvement ensuring metrics and key performance indicators are met and exceeded, specifically those focused on eligibility assessment completion and revenue generated from marketplace and Medicaid conversions.
- Ensure optimal resource utilization and institute measures that result in greater cost effectiveness and efficiency in operations while ensuring high patient satisfaction.
- Oversees day-to-day operations to include managing workflows, compliance monitoring, performance management, teammate development and scheduling and administrative functions.
- Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.
- Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.
- Leads escalated aspects of direct report work to include teammate relation issues, recommending and approving teammate hires, performance evaluations of direct reports, KPI achievement, and patient complaints.
Licensure, Registration, and/or Certification Required:
- None
Education Required:
- Bachelor’s Degree.
Experience Required:
- Typically, requires 3+ years of experience in revenue cycle operations, preferably in scope with health coverage eligibility and enrollment. Minimum of 1 years in supervisory role managing staff, reimbursement and receivables management.
Knowledge, Skills & Abilities Required:
- Demonstrated leadership skills including project management, process improvement, problem-solving, decision making, prioritization, delegation, team building, customer service and conflict resolution.
- Strong interpersonal, communication and organizational skills.
- Strong background and knowledge in both hospital and revenue cycle operations/principles preferred.
- Strong background and knowledge in program management, government health plans and regulatory compliance
- Experience in executing change and results based upon data analytics.
- Self-directed, flexible and ability to handle a high degree of pressure with effective time management.
Physical Requirements and Working Conditions:
- This position requires travel, therefore, will be exposed to weather and road conditions.
- Operates all equipment necessary to perform the job.
- Exposed to a normal office environment.
- Occasionally lifts up to 20lbs
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
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What We Do
Advocate Aurora Health is the 11th largest not-for-profit, integrated health system in the United States. As a leading employer in the Midwest, Advocate Aurora Health employs more than 75,000 individuals including more than 22,000 nurses. Advocate Aurora is engaged in hundreds of clinical trials and research studies, and is nationally recognized for its expertise in cardiology, neurosciences, oncology and pediatrics. The organization contributed nearly $2.2 billion in charitable care and services to its communities in 2019.