Operations Manager

UnitedHealth Group - Rancho Cordova, CA3.6

30+ days ago
If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)

Primary Responsibilities:
Assist in planning, preparing and integrating facility Billing & collections processes with the COE during deployment
Manage the work of billing and collections team members by empowering, coaching, answering questions, giving guidance, and leading by example
Manage COE operations of Billing & Collections functions, ensuring timeliness, accuracy, compliance and standards fulfillment as defined in Sacramento COE Service Level Agreements
Ensure that adequate procedures exist for accurate and timely processing of Medicare, Medi-Cal, Medicaid, Specialty, Commercial / HMO and Workers Compensation bills
Ensure compliance with state and federal laws regulations for Medicaid, Medicare, non-government and other third party billings
Maintain ongoing knowledge of UB-92, HFCA 1500, and other mandatory state billing forms and filing requirements
Monitor on-line claim editing, submission and reconciliation procedures; ensure compliance with CPT, HCPCS and ICD-9 coding regulations and guidelines
Help coordinate follow-up within appropriate regulations of Medicare and Medi-Cal bills
Provide relevant guidance for Billing & Collections Supervisors and staff to resolve internal and external issues
Inform Operations Director of any significant issues in the Billing & Collections area (e.g., Billing backlogs, HIM bill drop delays, payer issues, vendor issues, etc.)
Stay abreast of regulatory requirements and company compliance policies, ensuring timely staff education
Help ensure that appropriate personnel policies are adhered to and any personnel problems are addressed in an appropriate and timely manner
Assist in hiring, managing and developing department staff to ensure appropriate skills base is present in the staff, as well as to ensure that skills needed for future needs are developed in advance of their need
Assist in establishing and monitoring controls to ensure appropriate submission and acceptance of electronic and manual bills
Monitor billed, rebilled, and collections summary reports and act on trends and/or root causes
Monitor Billing & Collections performance according to quality and productivity standards developed internally and documented in SLAs
Support completion of monthly trending analysis of COE billing & collections performance
Help coordinate and promote implementation and monitoring of standard master files, processes, reporting and education programs
Understand and communicate nuances of billing & collections various payers such as Medicare, Medicaid, HMO’s, PPO’s, IPA’s, employers, etc.
Manage Billing & Collections personnel, provide recommendations for hiring, promotion, and personnel action where appropriate
Assist Solutions Management and COE Implementation staff in company-wide initiatives such as the development of operational models, education programs and national contract compliance
Develop specific objectives and performance standards for each area of responsibility
Identify and implement process improvements to lower costs and improve service to facility customers
Identify opportunities for innovation, knowledge sharing and other leading practices within the COE and among peer group
Perform staff reviews and prepare performance documents for direct reports
Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement
Lead and motivate the staff associated with their line of business
Other duties as assigned

Required Qualifications:
5+ years of leadership experience in patient financial services or billing and collections revenue cycle
Project Management experience
Success in improving and managing employee engagement
Expertise in Microsoft Office, specifically Excel

Preferred Qualifications:
Undergraduate degree
Medical Experience
Hospital Patient Financial Services Experience

Careers with Optum360. At Optum360, we're on the forefront of health care innovation. With health care costs and compliance pressures increasing every day, our employees are committed to making the financial side more efficient, transferable and sustainable for everyone. We're part of the Optum and UnitedHealth Group family of companies, making us part of a global effort to improve lives through better health care. In other words, it's a great time to be part of the Optum360 team. Take a closer look now and discover why a career here could be the start to doing your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.