Jobs for People with MS: National MS Society

Description

This position is incentive eligible.

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Director Denial Operations with HCA Healthcare you can be a part of an organization that is devoted to giving back!

Benefits

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

• Free counseling services and resources for emotional, physical and financial wellbeing

• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

• Employee Stock Purchase Plan with 10% off HCA Healthcare stock

• Family support through fertility and family building benefits with Progyny and adoption assistance.

• Referral services for child, elder and pet care, home and auto repair, event planning and more

• Consumer discounts through Abenity and Consumer Discounts

• Retirement readiness, rollover assistance services and preferred banking partnerships

• Education assistance (tuition, student loan, certification support, dependent scholarships)

• Colleague recognition program

• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note: Eligibility for benefits may vary by location.

Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the HCA Healthcare family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Director Denial Operations to help us reach our goals. Unlock your potential!

Job Summary and Qualifications

The Utilization Review Services (URS) Director of Denial Operations collaborates with Case Management, Parallon, Regulatory Compliance and Payer Contracting & Analytics (PCA) to assess, define and execute Denials Management strategies for HCA. The Director will establish and lead dedicated URS resources focused on reducing new denials and final denial write-offs. The Director will work with Division Denials Managers and Parallon to analyze denial data and the identification of root causes occurring during the payment cycle. The position will support the mitigation of denials related to hospital and revenue cycle operations, including but not limited to medical necessity, missing/invalid authorizations, notification of admissions, timely filing, and/or technical denials. The position will work to identify and support key strategies by leveraging data from various financial and operational systems. The Director will educate and support the Division Denial Managers and others on effective denial analysis techniques and processes to reduce denials across the organization. This position will maintain a reporting and escalation process for communicating third-party payor issues to PCA, Parallon, and Case Management URS for consideration and resolution during contract negotiations and settlements. This position requires solid leadership, trust building, team building, and change management to influence and lead other HCA resources and business partners to ensure the success of all organizational initiatives. This individual must possess strategic vision, excellent communication skills, proven facilitation skills, proven motivational capabilities, an executive presence, and a demonstrated track record of delivering results and attaining goals.

What you will do in this role:

• Provides leadership, oversight, and accountability for the operational effectiveness of the denial programs developed to support the organization at the corporate, division, and facility levels

• Directs activities of the URS Denial Operations team

• Identify and support key strategies by leveraging data from various financial and operational systems Ensures Denials strategies are implemented and adhered to across the organization

• Identifies payer denial opportunities and works directly with Case Management/URS, Parallon, and PC&A resources to develop resolution strategies

• Partners with PC&A and URS leaders to develop contractual language recommendations to improve payor relations and reduce denials.

• Monitors effectiveness of Denial Management Action Teams across the enterprise through action plan development and resolution tracking

• Collaborates with other operational areas to develop new tools and processes to reduce and prevent denials

• Implements and supports processes that demonstrate compliance with regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives as it relates to utilization management.

• Works directly with CM Analytics, CM Technology, URS QA, and Parallon teams to ensure consistent processes and standards are supported in defined tools and reports and are communicated to appropriate levels of the organization

• Develops a high-performance and continuous improvement culture that values learning and a commitment to quality.

• Communicates timely and effectively in a matrix environment

• Escalates issues to Case Management / URS leadership as necessary

• Attracts, develops, and retains talent across the organization to ensure a succession plan.

What qualifications you will need:

• Bachelor’s degree required. Degree requirement may be substituted by current enrollment in a Bachelor Degree program or equivalent work experience with CEO approval.

• 7-10 years of healthcare management experience required

• Minimum of 5-7 years of management experience in healthcare revenue cycle, financial or clinical operations

HCA Healthcare (Corporate) , based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities , every person has a solid foundation for success. Nashville is also home to our Executive Development Program , where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

Be a part of an organization that invests in you! We are reviewing applications for our Director Denial Operations opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.