DaVita Careers

Denial Management Manager

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Position Description

GENERAL PURPOSE OF THE JOB

This position oversees and provides leadership to the ROPS Denial Management Team (DMT) and will assist to drive denial and controllable bad debt process improvement initiatives.

 

SUPERVISORY RESPONSIBILITIES: Yes

This position has full responsibility and/or has input into decisions concerning the recruitment, training, professional development, performance management including termination, and retention of teammates necessary for the team to achieve key departmental goals and objectives.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.

 

Leadership Responsibilities

·         Oversee the ROPS Denial Management team

·         Provide direction, mentoring, coaching, and performance management to direct reports

·         Help direct reports overcome any organizational obstacles encountered during projects

·         Ensure high quality customer service according to department and company policy

·         Establish team and teammate performance expectations and goals

·         Identify training needs and coordinate training programs to keep teammates up-to-date on DaVita policies, new laws and regulations impacting work, and other information necessary to maintain teammates' knowledge of department processes and goals

·         Address teammate relations issues appropriately and escalate to director as necessary

·         Oversee and monitor team productivity and progress of specific area job functions

·         Respond to issues, concerns, and questions

·         Hire, train, retain, and develop a world-class denial management team

·         Establish, communicate, and ensure departmental goals and objectives are achieved

·         Assist with teammate employment activity such as hiring, processing ePCN's promptly, promoting, job performance, evaluations, PTO, and disciplinary action as required

·         Write and conduct teammate annual Performance Development Reviews (PDRs) as required

·         Address teammate relations issues appropriately and escalate to director as necessary

·         Maintain teammate records in compliance with DaVita policy's and any applicable laws

·         Compile monthly operations reviews based on input from team

·         Facilitate partnerships with other teams in the village and serve as a liaison between operations and other departments to ensure business needs are met in an efficient and effective manner

·         Understand and communicate DaVita company policies and procedures

·         Work with People Services and manager to recruit teammates with appropriate skills and experience

·         Maintain familiarity with and communicate to teammates DaVita programs impacting teammates

·         Know, understand, and follow DaVita teammate guidelines as well as local safety and security policies and procedures

 

Projects/Analytics

·         Develop innovative solutions to complex billing problems and provide recommendations for improvement and efficiency in processes

·         Lead and drive denial and controllable bad debt prevention projects

·         Identify system and process improvements to reduce and prevent denials

·         Perform root cause analysis and create detailed reports for strategic business issues and opportunities

·         Provide accurate and timely reporting of performance metrics to the senior leadership team as required or scheduled

·         Communicate and facilitate review sessions on key denial findings with leadership, key stakeholders and functional areas

·         Engage appropriate teammates or support teams to develop and implement solutions

·         Maintain reporting continuity, integrity, and communication among analytical departments

·         Utilize innovative problem solving tactics in order to streamline process and maximize collection efforts.

·         Support the Reimbursement Operations Management Team via business acumen and technical knowledge

·         Serve as a liaison between operations and other departments to ensure business needs are met in an efficient and effective manner

·         Meet tight deadlines in a time sensitive and resource constrained project environment

·         Provide frequent updates to director regarding the status of activities and initiatives

 

Other Duties

·         Champion the DaVita Mission and Values both internally and externally

·         Perform other duties as assigned or required

·         Travel required: up to 10%

 

Qualifications

MINIMUM QUALIFICATIONS

Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required.

·         Management experience demonstrating willingness, desire, and ability to supervise with aptitude for coaching, mentoring, training, and developing teammate skills

·         Critical thinker with demonstrated ability to perform root cause analysis, draw conclusions, solve problems, prepare and implement action plans, and lead improvement initiatives

·         Demonstrated ability to work effectively at both detail and big-picture levels and to drive projects forward

·         Strong written, verbal, and interpersonal communication skills with an acute ability to listen attentively and to communicate effectively throughout all levels of the organization

·         Demonstrated project management and/or consultative skills when addressing complex inquiries from teammates/customers

·         Strong time management skills with the ability to manage/lead multiple tasks and projects simultaneously and in a multi-site environment

·         Proven ability to own and be responsible for key projects and processes

·         Ability to make timely and quality decisions

·         Ability to influence peers and build strong relationships across departments/teams and can demonstrate poise and assertiveness in holding peers accountable

·         Strong computer skills and proficiency in Microsoft Office (Excel, Access, Word, Outlook, and PowerPoint)

 

PREFERRED QUALIFICATIONS

·         Bachelor's degree required from accredited university with a focus in Business, Project Management, Engineering or Health Admin.

·         Prior health care reimbursement, denial management, and/or revenue cycle experience

·         2 or more years experience in similar role

·         Ability to influence peers and build strong relationships across departments/teams and can demonstrate poise and assertiveness in holding peers accountable

·         Strong computer skills and proficiency in Microsoft Office (Excel, Access, Word, Outlook, and PowerPoint)

·         Previous leadership and supervisory experience

·         SDLC experience, other project management approaches

·         Data analytics experience

·         Advanced computer skills and proficient in MS Office applications (Excel, Powerpoint, Access)

 

 

ESSENTIAL BEHAVIORS, SKILLS, AND ATTITUDES REQUIRED FOR SUCCESS IN THIS POSITION

          Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions

          Strong understanding of health care revenue cycle, reimbursement policies and business processes with the ability to communicates concepts/ideas to leadership or translate business requirements into technical requirements

          Strong analytical skills with the ability to seek out underlying assumptions through probing, questioning, and listening

          In-depth understanding of Revenue Operations and the roles of teammates in mission accomplishment

          Know the data relationships within the systems as well as how the data interfaces to and from other systems

          Proven leadership skills and the ability to collaborate across functions and with all levels of the organization

          Demonstrated verbal, interpersonal and written communication skills; ability to interact positively with teammates at various management levels across the company

          Demonstrated ability to manage multiple projects, deadlines and multiple priorities in a fast-paced, ever changing and evolving business environment with shifting time frames

          Demonstrated sound judgment and problem-solving skills to resolve unique and challenging issues and/or concerns

          High level of personal and professional integrity

          Strong customer service skills and commitment to service excellence

 

LANGUAGE SKILLS

Fluent in the written and verbal skills necessary to perform successfully the essential functions, duties, and responsibilities of the position.

 

Vision requirements

Vision adequate to perform essential duties and responsibilities of position.

 

PHYSICAL DEMANDS

Physical requirements can vary. These must be reviewed with management. However, in general, the position requires the following physical activities:

Ability to lift minimum of 5 pounds to a maximum of 15 pounds unassisted; able to perform repetitive standing, sitting, stooping, walking, stretching, reaching, lifting, and use full range of body motions.

 

WORK ENVIRONMENT        

Level III - Moderate noise (examples: business office with computers and printers, light traffic)

No required tasks involve greater exposure to blood, body fluids or tissues than would be encountered by a visitor. The normal work routine involves no exposure to blood, body fluids or other hazardous conditions.

 

 

Position Summary

  • Job Title: Denial Management Manager
  • Job Function: Other - Corporate Office
  • Location: 1423 Pacific Ave, Tacoma, Washington