Job Information

Providence Senior Manager, Revenue Cycle Quality and Performance, Remote in Washington

Description

Providence St. Joseph Health is calling a Senior Manager, Quality and Performance to work remotely within our footprint states: AK, CA, MT, OR, TX and/or WA.

We are seeking a Senior Manager. Quality and Performance for Providence's Revenue Cycle function to report directly to the quality assurance function leadership. You'll work closely with members of the revenue cycle team across the organization, as well as the Revenue Cycle's leadership teams to help them effectively run their team and business.

This individual will be responsible for the assignment and distribution of audit volume and productivity monitoring of all Central Audit Team staff. They will assist in the design and refinement of audit process, interface, database (SQL) and reporting package for individual caregivers and function leadership. The Sr Manager will review the audit findings with the Program Supervisor and coordinate both department and caregiver performance reporting (audit findings). This individual will drive process improvement initiatives for both Revenue Cycle Departments and the Quality Assurance Department through improved workflow, reporting and training. The Sr Manager will also collaborate with the BI team to develop a tool to manage audits and report results of both the audit department and operational department performance. The Sr Manager will also assume responsibility of any concerns or feedback from the caregiver or operational leadership as it relates to the accuracy of the audit findings.

This individual is highly organized and like to push initiatives forward. They are data-driven and like to develop insights based on analysis. This individual is an excellent communicator and forms trusting relationships with people easily. You are proactive, flexible and willing to adapt to changing business needs, thrive in ambiguity, and managing multiple moving parts.

Responsibilities:

  • Reviews results of “audit-the-auditor” audits (level 1 and level 2); supports Program Supervisor with L1-L2 audit comparisons and performs targeted staff audits if performance metrics are not being met (productivity, accuracy based on L1-L2 comparison, and inter-rater scoring).

  • Manager is responsible for reviewing feedback/disputes from caregiver after audit findings are shared with caregiver and/or operational leadership.

  • Establishes and re-evaluates performance metrics (productivity, accuracy and inter-rater) for Specialists (L1) and Supervisors (L2) on a monthly basis. Seeks ways to improve processes or training to achieve optimal performance with a high degree of accuracy.

  • Assist in refining QA program development (job aids, SOPs, trainings); facilitates development of random samples of claims to be included in audit reports (L1 and L2) along with dashboard statistics for both QA Team and caregiver performance metrics.

  • Provides strategic advice and guidance to the Revenue Cycle Quality and Performance Management function. Identifies, and reports statistics, trends, and analysis to management; analyses data, prepares and presents project reports for management, clients or others

  • Responsible for the quality of the audit results published in the dashboard and shared with Revenue Cycle Leadership. Works closely with Program Supervisors, QA Director and Operational Leadership to generate meaningful and actionable reporting. Solicits feedback from leadership and incorporates into the reporting and audit process.

  • Develop detailed job aids and document full QA process to educate colleagues. Ensures all training materials are up to date and current; supports Program Supervisors with training and staff oversight when necessary.

  • Reviews the overall average audit score on a weekly/monthly basis. Collaborates with Revenue Cycle Leadership to identify ways to improve accuracy of caregivers. Provides recommendations and offers support in the development of an educational campaign or strategic imitative to improve caregiver accuracy. Identifies metrics to track the success of an improvement campaign (ROI).

  • Is the point of escalation if QA Supervisor identifies staffing challenges, productivity or other issues with Specialists or Supervisors. Escalates performance issues to Senior Leadership, if necessary.

  • Performs ad-hoc analyses on an as need basis; identifies, recommends, and implements approved process improvements

  • Works with QA Director to track the ROI for the Quality Assurance Program. Develop a methodology to identify process improvement opportunities at the caregiver and department level and the associated monetary return on the improvement.

Required qualifications:

  • Bachelor's Degree in Business Administration, Healthcare Administration, Public Administration, or a related field.

  • 8 years of experience as a revenue cycle Quality Assurance Manager, or related role

  • 8 years of experience working at or with large health systems

Preferred qualifications:

  • Master's Degree in Business Administration, Healthcare Administration, Public Administration, or a related field.

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Salary Range:

NorCal (Napa, Sonoma)

Min: $66.47 , Max: $109.14

Southern California, NorCal (Humboldt) Alaska (Kodiak, Seward, Valdez)

Min: $59.25, Max: $97.28

WA Puget Sound Oregon (Portland) Alaska (Anchorage)

Min: $56.84, Max: $87.00

Oregon (Hood River, Medford, Seaside)

Min: $52.99 Max: $53.14

Eastern Washington (Richland, Spokane, Walla Walla)

Min: $50.58 , Max: $83.04

Montana

Min:$45.76, Max: $75.14

Texas

Min:$43.45, Max: $71.18

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 151933
Company: Providence Jobs
Job Category: Operations & Support
Job Function: Information Technology
Job Schedule: Full time
Job Shift: Day
Career Track: Leadership
Department: 4001 SS RC PMO
Address: OR Portland 4400 NE Halsey St
Pay Range: $56.84 - $93.33
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.