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Providence Regional Manager Managed Care Finance in Mission Hills, California

Description:

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Providence is calling a Regional Manager Managed Care Finance (Full-Time/Day Shift) to Providence Facey Medical Foundation in Mission Hills, CA

Please upload a current resume reflecting all relevant professional experience.

We are seeking a Regional Manager Managed Care Finance who will provide financial leadership for the California Region of Physician Services. Performs special projects, as requested, for the Director, CFO, COO, and CEO. Assists and helps guide the Managed Care Finance team in capitation analysis, reconciliation, preparation of presentations and reporting, routine and ad hoc projects and processes, and required special analysis. Plays an active role in productivity reporting and analysis on ministry and regional levels. Additional areas of responsibility include accurate reporting of statistical information to internal and external sources, program financial analysis, financial leadership and troubleshooting.

In this position you will:

  • Deliver upon the service expectations of both our patients and fellow staff members by listening to their needs; engaging in positive interactions; and following through on promises made in a thoughtful, efficient, timely and courteous manner so that their total outcome is better than expected

  • Respect the dignity, confidentiality and privacy of patients

  • Work in a safe manner, adhering to general safety precautions and standards

  • Report any unsafe conditions to their supervisor and/or the safety hotline

  • Point person for RAF Reporting and Analysis, Capitation Payment Reconciliations, Software Vendor Relationship Management, Coding Effectiveness Reporting and Analysis, Financial Analytics and ad hoc reporting related to foundations, medical groups and other special projects in support of the region. Key resource for processes such as Pay for Performance, Quality Measures and Stars Reporting:

  • Provide leadership and guidance to the Finance team on comp/benefits, PTO, team building

  • Help as the liaison for Finance with the medical groups’ leadership. Support the foundations’ Sr. Leadership team with strategic initiatives

  • Oversee the daily operations of the Managed Care Finance team, Financial Analysts, Revenue Recovery team, Data Quality Assurance team, Managed Care Finance Leads and Supervisors

  • Oversee financial statement creation and analysis process for Managed Care, Capitation

  • Develop and maintains various compensation models while maintain confidentiality

  • Create and manage productivity reports

  • Develop financial projections and ROI calculations as required

  • Support and assist the Regional Director in all relevant duties and tasks assigned

  • Broad operational support for all California medical groups and the foundations:

  • Sit in and represents the Regional Director of Managed Care Finance and the CFO in Capitation, software, process improvements, HCC/RAF, Quality, Coding, Compliance meetings

  • Communicate clearly, timely, and effectively with all levels and functions to create an atmosphere of mutual respect, openness and encouragement

  • Maintain the confidentiality of the meetings attended

  • Build rapport and establishes credibility with the physician leadership and members, and Providence regional and ministry senior leadership

  • Provide excellent customer service to physicians and their office staff

  • Able to travel to all regional sites in a consistent, timely and efficient manner; holds effective meetings and leads workgroups; assigns and takes over deliverables; reports to and coordinates with the regional director on the priorities and workload management, strives to exceed expectations

  • Serve as content expert in specific areas, and performs other operational duties, as assigned

  • Demonstrate effective management skills:

  • Manage the Managed Care Finance Department within the established budget

  • Hire and retain qualified staff; ensures new employees are oriented to their department and well trained for their jobs

  • Organize the department workload and establishes work standards to promote efficiency and productivity

  • Conduct departmental staff meetings on a monthly basis or more frequently if needed and maintains minutes of all meetings

  • Motivate and manages staff to ensure that performance standards are met or exceeded

  • Give timely and constructive feedback on performance; documents all corrective counseling

  • Prepare and conduct fair and objective performance appraisals in compliance with the organization’s performance management program, procedures, standards and guidelines

  • Ensure that adequate in-service education is available to staff members

  • Keep staff apprised of changes in organization and departmental policies

  • Maintain a high degree of professionalism:

  • Demonstrate the ability to make decisions, take appropriate action and follow tasks through to completion

  • Recognize the implications of new situations and develops workable solution

  • Demonstrate a willingness to accept new responsibilities

  • Respond cooperatively to managers and staff members in other departments to promote teamwork

  • Act as a role model in demonstrating the customer service standards of the organization

  • Demonstrate a commitment to personal growth and development by participating in external activities related to professional goals

  • Attend departmental meetings as appropriate and contributes ideas for improving efficiency, productivity and patient satisfaction

Qualifications:

Required qualifications for this position includes:

  • Bachelor's Degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field

  • Five (5) years of Related leadership experience

  • Experience with quality improvement tools, methodologies and improvement teams

  • Experience in HCC and RAF calculations

  • Significant experience working at a strategic level in a mid to large size organization, preferably with physicians

  • Effectively present information to physicians and senior staff, and apply presentation skills at all levels of the organization

  • Ability to translate ideas into action, establish processes, monitor and track performance

  • Proactive commitment to advancing healthcare outcomes with a patient-first approach

  • Strong critical thinking and analytical skills. Well-developed oral and written communication skills

  • Able to manage accelerated work pace with multiple deliverables

  • Demonstrated ability to establish a consulting relationship with senior internal and external customers, especially physicians, and maintain their trust and support

  • Demonstrated ability to access and manage pertinent clinical, financial and other information, and reach sound conclusions from variety of sources

  • Able to recognize and generate new or modified approaches that are results-oriented

  • Strategic business focus and understanding of how projects are tied to business goals and objectives

  • Thorough understanding of data and encounter reporting, ASM submissions, clearinghouse edits

  • Knowledge of Quality Measures (HEDIS, Stars, P4P). Understanding of Coding and Compliance

  • Strong computer skills: MS Word, Excel, PowerPoint, Access, Visio, Project, Adobe, other

  • Extensive organization, communication and facilitation skills - able to interact credibly with physicians, executive management and business stakeholders to clearly articulate complex messages

  • Able to formulate and communicate key priorities that guide and focus the efforts of others

  • Able to create an open environment where conflicts as to project methods and priorities can be aired and resolved in an objective and collaborative manner

About the hospital you will serve.

Facey Medical Group is a multi-specialty medical group with over 160 physicians providing care to the growing population in the North & East regions of Los Angeles & Ventura Counties. Twelve medical clinics, including two urgent care centers and dedicated women's centers, are located across the San Fernando, Santa Clarita and Simi Valleys. The group began as a single medical practice over 90 years ago.

Facey is part of Providence, an integrated, not-for-profit network of hospitals, care centers, medical clinics, affiliated services and educational facilities across Alaska, California, New Mexico, Montana, Oregon, Texas and Washington.

We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Non-Clinical Lead/Supervisor/Manager

Location: California-Mission Hills

Req ID: 292085

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