DescriptionThis position is incentive eligible.IntroductionDo you want to join an organization that invests in you as a Unit Manager Medicaid Eligibility? At Work from Home, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.BenefitsWork from Home, 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.You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Unit Manager Medicaid Eligibility like you to be a part of our team.Job Summary and QualificationsThe HCA Unit Manager supervises HCA PSRs and Leads. Accomplishes department objectives by managing, planning and evaluating HCA Department activities. Is responsible for the quality assurance of the Medicaid application process. The HCA Unit Manager must actively participate in hiring, training and counseling staff as needed. He/she must track department trends, identify issues and provide feedback to Director of Operations. He/she must also be proactive in providing guidance to the staff in regards to timely and appropriate account follow up, as well as keeping Area Managers informed on the overall quality of the field team. He/she also must perform additional tasks as described under the position responsibilities.What you will do in this role:
Supervises assigned HCA Department staff
Maintains staff by recruiting, selecting, orienting, and training employees; maintaining a safe, secure, and legal work environment; developing personal growth opportunities
Establishes strategic goals by gathering pertinent business, service, and operations information; identifying and evaluating trends and options; choosing a course of action; defining objectives; evaluating outcomes
Maintains quality service by enforcing quality and customer service standards; analyzing and resolving quality and customer service problems; identifying trends; recommending and implementing protocol improvements
Identifies, develops and documents policies and procedures as needed
Reviews reports daily and account activity to identify trends, issues, and ensure compliance with internal and external protocols
Attends and actively participates in routine calls with hospital clientele, shared service center and senior leadership
May be required to attend or facilitate meetings and/or presentations at client sites
Promotes and maintains harmonious and effective relationships and communication with other departments and clients
Assists Director of Operations as needed
Travel as needed throughout the country
Adheres to and supports organizational IT&S standards, policies, and procedures.
Adheres to Code of Conduct.
Performs other duties as assigned.
Manages Employee timecards, addresses attendances and enforces Performance Improvement Plans for Attendances as needed
Identifies clinical challenges including Dx, commodities and new levels of care that require additional education training and conducts biweekly clinical training with Nursing staff in order to reduce Denials
Reviews and reduces Denials by identifying trends and addressing Adjudication patterns with State Agencies
Acts as primary liaisons with State Agencies that Parallon submits Authorizations for
Develops clinical training curriculum for new staff and ongoing training for existing staff
Reviews and addresses Productivity as a Department and with each Team member and develops Performance
Improvement Plans for Nurses who cannot achieve the required production amount
Completes bi‐weekly "check‐ins" with individual staff members to: addresses attendance and ensure staff is aware of occurrences, help prioritize caseloads, address challenges and review performance
Reviews all operational reports in preparation for Month‐end distribution
Facilitates back‐up functions of the following duties: Posting, MR retrieval, filing, review of SPMS, Approval Reviews and Assignments
Acts as primary contact for SSCs, individual facilities and external clients
Reviews and manages SPMS calls with SSC and Patient Access during weekly calls
Communicates issues to Regional Director of Operations and RVP impacting performance and quality of submissions
Completes preliminary research and develops implementation plans for new client onboarding
Facilitates Authorization and clinical In‐services requested by clients
Completes Write‐offs for Admissions where Authorization was Denied by State Agency
Reviews and addresses accounts on Authorization related Exception Reports
Conducts Monthly spot check of Authorization Completed accounts for quality assurance
Spot‐checks active accounts against Department standards to ensure quality of work habits
Conducts reviews of PME to ensure movement of phases in Authorization Phase is correct and updated Regional
Director of Operations for both Authorization and Irvine Specialty center of trends related to staff and improvement opportunities
Conducts Productivity reviews with Regional Director of Operations and RVP to provide department updates and share barriers to achieving goals
Develops workflows to ensure Productivity and client standards are met
Coach and mentor staff facilitating awareness of priorities, appropriate problem resolution and communications to clients and within CSO
Qualifications:
AA Degree or Bachelor’s Degree Health Care preferred
LVN license or above required
3 years minimum supervisory experience required.
2 years Medicaid or Financial Counseling experience required.
Knowledge of Utilization Management and Authorization(s) required.
Must be knowledgeable of Medicaid and Government Program eligibility and processes.
Proficient with computer and basic software including Excel, Word and Outlook.
Basic knowledge of office equipment use and maintenance including network printer, copier, postage machine, fax machine.
Knowledge of alpha/numeric filing systems required.
"Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.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.""Good people beget good people."- Dr. Thomas Frist, Sr.HCA Healthcare Co-FounderWe are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Medicaid Eligibility Area Manager opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Full-time