Associate Director - Patient Financial Services Quality Improvement - 2001757
Reporting to the Director of Patient Financial Services, the Associate Director of PFS Quality Improvement will direct the department's performance improvement, training and development, internal audit, quality assurance and compliance efforts. It is expected the Associate Director Q.I. will work in close collaboration with the Associate Director Patient Accounting Operations to identify and realize financial, educational and efficiency opportunities as well as mitigate quality and compliance risk within the Patient Accounting Department. The Associate Director Quality Improvement will drive departmental transformation through workflow optimization, staff education and training and compliance, quality and financial audit programs. This role will serve as a change agent analyzing, documenting and evolving workflow to ensure current state/future state best practice. Candidates must have significant management experience within the healthcare revenue cycle continuum or hospital facility billing with a demonstrated history of successful collaboration with Revenue Integrity/HIM, Compliance, Finance and Information Technology Departments. This position will develop quality audit review programs which support day to day operations and productivity, ensure regulatory compliance, support system and service line "go-lives" and measure and drive performance improvement initiatives.
Duties of the Associate Director of PFS Quality Improvement may include the following but are not limited to:
Identifying areas of compliance, quality and financial risk and opportunity to develop performance improvement projects and initiatives.
Analyzing, documenting and optimizing departmental work flows.
Developing staff work-aides, training and educational materials. Including manuals, work flow diagrams and policy/procedure narratives.
Creating, managing and/or completing quality and financial performance audits.
Maintaining a knowledge base of regulatory and compliance requirements disseminating materials and providing education to staff.
Operationalizing work flow, benchmarking and audit program changes as regulatory, financial and operational needs require.
Creating and distributing department wide communication notifying staff of new and updated work processes.
Mentoring and providing feed-back to staff on areas of success and improvement (performance plans.)
B.S. Accounting/Finance, Health Information Management, Healthcare Administration, Computer Science or related field. In lieu of a degree 10 years plus experience Managing/Directing within an Acute Care Hospital/Health System Revenue Cycle or Business Office.
Experience in planning, leading, directing and managing revenue cycle projects.
Extensive experience with healthcare reimbursement and facility claims submission, collection and analysis (DRG, APC, APG, Managed Care Contracts, UB-04, 837i, 835)
Broad understanding of insurance eligibility and benefit design, prior-authorizations, ABN's, coordination of benefits, financial clearance and financial assistance.
Healthcare denials and appeals management experience. Including an Understanding of healthcare utilization management, medical necessity criteria and administrative, clinical and DRG/coding denials/appeals processes.
Experience with governmental and third party audits including RAC, Livanta and HMS.
High degree of proficiency utilizing and/or configuring hospital patient accounting, claims scrubber and contract management information systems.
Working knowledge of CPT, HCPCs and ICD-10 coding principles.
Excellent written and verbal communication skills.
CCS, CCS-P, CPC, CCDS, RHIA or RHIT certification.
Knowledge of Cerner Unity/Invision Patient Accounting system configuration and master files.
Experience with work flow visualization software (Visio.)
Proficiency with MS PowerPoint and/or Desktop Publishing software.
Experience utilizing visualization software (Tableau, MS Power BI, etc.)
Proficient with billing or healthcare financial decisions support software and/or query tools.
Experience creating and maintaining Revenue Cycle Key Performance Indicators and Dashboards.
Special Notes: This position will remain posted until filled or for 90 days max.
An initial review of all applicants will occur two weeks from the posting date. For full consideration, applications must be received before the initial review date (which is within two weeks of the posting date). If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.
Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
All Hospital positions are subject to changes in pass days and shifts as necessary. This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.
The selected candidate must successfully clear a background investigation. Prior to start date, the selected candidate must meet the following requirements: Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services (The hiring department will be responsible for any fee incurred for examination), submit (3) written references, and provide a copy of any required New York State license(s)/certificate(s). Please be advised that failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.
The best ideas in medicine start with the best people. At Stony Brook Medicine, our highest calling is to put the power of ideas to work in our patients' lives. Stony Brook Medicine integrates and elevates all of our health-related initiatives: education, research and patient care. Stony Brook Medicine is Long Island's premier academic medical center. With 603 beds, we serve as the region's only tertiary care center and Level 1 Trauma Center, and are home to the Stony Brook Heart Institute, Stony Brook Cancer Center, Stony Brook Children's Hospital, Stony Brook Neurosciences Institute, and Stony Brook Digestive Disorders Institute. We also encompass Suffolk County's only Level 4 Regional Perinatal Center, state-designated AIDS Center, state-designated Comprehensive Psychiatric Emergency Program, state-designated Burn Center, the Christopher Pendergast ALS Center of Excellence, and Kidney Transplant Center. It is home of the nation's first Pediatric Multiple Sclerosis Center.
Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
This function/position has been designated as "essential." This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.
Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor's Office of Employee Relations at (518) 474-6988 or via email at [email protected] .
IF YOU NEED A DISABILITY-RELATED ACCOMMODATION, PLEASE CALL THE UNIVERSITY HUMAN RESOURCE SERVICES DEPARTMENT AT (631) 632-6161 OR THE UNIVERSITY HOSPITAL HUMAN RESOURCES DEPARTMENT AT (631) 444-4700. IN ACCORDANCE WITH THE TITLE II CRIME AWARENESS AND SECURITY ACT, A COPY OF OUR CRIME STATISTICS IS AVAILABLE UPON REQUEST BY CALLING (631) 632-6350. IT CAN ALSO BE VIEWED ON-LINE AT THE UNIVERSITY POLICE WEBSITE AT http://www.stonybrook.edu/police
Official Job Title: TH Supervising Financial Analyst
Job Field: Administrative & Professional (non-Clinical)
Primary Location: US-NY-East Setauket
Department/Hiring Area: Patient Accounts-Stony Brook University Hospital
Schedule: Full-time Shift: Day Shift Shift Hours: 8:30am-4:30pm Pass Days: Sat, Sun
Posting Start Date: Jul 23, 2020
Posting End Date: Oct 22, 2020, 3:59:00 AM
Salary: Commensurate with experience
Salary Grade: SL5
Internal Number: 2001757
About Stony Brook University
FROM ITS BEGINNINGS A HALF-CENTURY AGO, STONY BROOK UNIVERSITY HAS BEEN CHARACTERIZED by innovation, energy and progress, transforming the lives of people who earn degrees, work and make groundbreaking discoveries here. A dramatic trajectory of growth has turned what was once a small teacher preparation college into an internationally recognized research institution that is changing the world.