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 Quality Assurance Manager is responsible for leading and managing a team of QA specialists performing quality inspections according to policies and procedures. The individual collaborates with internal and external business partners to drive accountability, provide recommendation for process improvements and improve overall quality of critical business processes. ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Meeting and Managing Relationships with key stakeholders to discuss common understanding of QA process, audit issues, and Action Plans
- Reviews QA monthly reports that are prepared for site and processes management, surfaces relevant issues, analyzes and develops corrective action plans.
- Supervises, plans, organizes and directs the daily activities of the QA department and monitor QA Specialists performance in terms of volume and accuracy
- Anticipates future changes/needs, creating strategic and operational plans for addressing them.
- Driving process improvements opportunities and Prevention, which includes leading or Pariticpating in AR Level projects
- Resolves corporate interface problems which cannot be resolved at the supervisory level.
- Working with QA Leads to build specific audit plans aimed to achieve employee and business success.
- Ensures accurate and timely documentation of Policies and Procedures, Internal documentation, training guides and reference materialall
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 (titles) 2 - 3 leads
Indirect Reports (titles) 15-20 QA SpecialistsQualifications:Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. 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.
- Advanced knowledge of healthcare A/R
- Excellent working knowledge of Patient Financial Services operations with specific focus on collections
- Excellent written and verbal communication skills.
- Strong knowledge of Microsoft Excel, Word, Outlook and PowerPoint.
- Ability to take ownership of client issues and collaborate with internal business partners to drive accountability and process improvements, reducing denials, disputes, appeals and bad debt.
- Ability to identify problems, gather and analyze information skillfully and provide recommendations for process improvements.
- Demonstrated ability to build strong working relationships with key internal and external stakeholders (Centralized Operations, Compliance, Facilities).
- Ability to hire, performance manage and coach team members.
- Ability to work independently in a fast paced environment
- Change agent: Ability to challenge the status quo, identify improvement opportunities and carry them thru execution
- Ability to motivate and mobilize Teams, creating a cohesive Team environment. Ability to prioritize, organize people and tasks
- Able to assist Director in developing and implementing QA Strategy, including the design of the QA Framework for Centralized Operations.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
- 4 year college degree in Healthcare Administration, Business or related field preferred.
- 3 years of experience in healthcare administration with at least 2 years of experience in Centralized Operations Billing, Cash Collections, Denials, Disputes.
- Previous Leadership experience as a Manager or Supervisor
- Six Sigma training preferred
- Medical billing and claims experience with an understanding of healthcare reimbursement process. And Extensive knowledge on critical business processes, primarily Billing, Collections, Dispute and Denial Management for different line of businesses (Medicare, Medicaid, Managed Care, etc).
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 for long periods of time, use computer and answer telephone.
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
- Moderate work noise
- Call Center environment with multiple workstations in close proximity
- Approximately 10% travel may be required