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Manager, Revenue Cycle Compliance-remote

  • Job ID 1905019471
  • Date posted 05/14/2019
  • Facility Conifer Health Solutions
Description:

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

The Manager, Revenue Cycle Compliance contributes to Conifer Health�s (Conifer) purpose by providing day-to-day leadership to the compliance program designed to ensure Conifer fully complies with its Standards of Conduct and all applicable laws and regulations. The Manager, Revenue Cycle Compliance supports his/her respective area(s) of Conifer�s Ethics and Compliance program which may include, but not be limited to: Revenue Cycle Compliance, Monitoring and Oversight, Regulatory Change Management, Vendor Oversight and Compliance Operations.

The Manager, Revenue Cycle Compliance develops, implements, and oversees core elements of the ethics and compliance program; including (1) maintaining and expanding visibility of the compliance program at all levels within the organization and (2) ensuring there is an effective compliance program and oversight in place to remain compliant with all applicable local, state, federal, and international rules, regulations and administrative requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

  • Functions as a revenue cycle compliance (Hospital, Ambulatory Surgical Center and Physician) subject-matter expert for responding to revenue cycle-related questions and providing consultative guidance for revenue-cycle related investigations.

  • Participates in the development and implementation Revenue Cycle Compliance portion of Conifer�s Annual Ethics and Compliance work plan.

  • Reviews and assesses risk assessment findings

  • Oversees and/or performs Work Plan-related reviews and projects by defining review/projects scopes and processes; gathering and analyzing data; and documenting findings.

  • Drafts meaningful audit reports.

  • Collaborates with Operations to develop and implement effective corrective action plans.

  • Routinely uses data analytics to identify and address potential compliance risks.

  • Monitors, analyzes, and interprets regulatory changes related to revenue cycle. Assists in overseeing the efforts to respond to new or changing regulations, including but not limited to communicating regulations to leadership and affected departments, and participating in implementation work teams.

  • Advises on and develops policies and procedures related with revenue cycle compliance implications.

  • Collaborates with key leadership, team members, contractors and other stakeholders throughout Conifer to promote a culture of compliance.

SUPERVISORY RESPONSIBILITIES

If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

  • Direct Reports: Specialist, Analyst, Sr. Specialist, and/or Sr. Analyst as applicable



Qualifications:
KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Ability to work independently with little supervision and seek guidance as needed to clarify assignments or request for information.
  • Excellent communication, customer service and time-management skills
  • Possess basic business skills, an understanding of general compliance operations and department goals in the healthcare environment.
  • Proficient with various desktop applications such as Microsoft Excel, Word, PowerPoint and/or Access.
  • Intermediate knowledge of relational database management systems
  • Must be a team player - Always willing to help in whatever way possible and go the extra mile to get the job done.
  • Intuitive and skilled at problem solving in anticipation of customer request
  • Have the ability to make logical correlations between data points to determine if analysis is accurate
  • Detail oriented, meticulous and accurate in completing tasks on time.
EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

  • Bachelor�s Degree in Business, Information Systems, Health Care Administration or related field or equivalent years of related Analyst experience required.
  • Minimum five years� experience in related area with two of these years being healthcare coding, billing, revenue cycle and/or healthcare compliance.
REQUIRED CERTIFICATIONS/LICENSURE

Include minimum certification required to perform the job

  • Variety of billing and/or coding certifications will be considered
  • Certified Healthcare Compliance (CHC) is preferred
PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Must be able to work in sitting position, use computer and answer telephone
WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Office Work Environment
Job: Conifer Health Solutions
Primary Location: Frisco, Texas
Job Type: Full-time
Shift Type: Days

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.


E-Verify: http://www.uscis.gov/e-verify

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