|Essential Duties:||1. Manages/supervises and develops an effective staff: providing effective communication, leadership, guidance and resources. Determines staff qualifications and competency: recruits, interviews, selects, hires, trains, orients, mentors, evaluates, coaches, counsels, and disciplines, and rewards.|
2. Translates departmental expectations of service into accountabilities, including communication and financial accountabilities, for staff involved in serving the patients of National Jewish Health. Monitors patient processes to verify compliance to expectations. Communicates success and opportunities to improve.
3. Establishes and maintains positive working relationships with clinicians, physician leadership, and clinic leadership. Identifies opportunities for service optimization and works to act upon opportunities.
4. Leads the patient intake, verification, authorization processes to ensure that care is provided in the correct setting with proper authorization and in compliance with regulatory and insurance standards.
5. Monitors broader National Jewish Health utilization working with contracting, PFS, ancillary areas and clinical teams to avoid unnecessary insurance write-offs or uncompensated services.
6. Collaborates with Patient Financial Services, Administrative services, Nursing and Faculty to ensure that National Jewish Health is aware of and operates in accordance with insurance front-end requirements.
7. Monitors UM workflow to assure timely authorizations and Quality Assurance of clinical calls and staff work. Provides appropriate feedback to staff and management.
8. Develops and produces routine and ad hoc reporting to support departmental and institutional strategic goals.
|Competencies:||1. Accountability: Accepts full responsibility for self and contribution as a team member; displays honesty and truthfulness; confronts problems quickly; displays a strong commitment to organizational success and inspires others to commit to goals; demonstrates a commitment to National Jewish Health.|
2. Attention to Detail: Accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time. Setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self-imposing standards of excellence rather than having standards imposed.
3. Building a Successful Team:Using appropriate methods and a flexible interpersonal style to help build a cohesive team, aligns vision with shared values, manages change and encourages innovation.
4. Coaching and Teaching Others:Providing timely guidance and feedback to help others strengthen specific knowledge/skill areas needed to accomplish a task or solve a problem.
5. Collaboration/Teamwork: Cooperates with others to accomplish common goals; works with employees within and across his/her department to achieve shared goals; treats others with dignity and respect and maintains a friendly demeanor; values the contributions of others.
6. Managing Conflict: Dealing effectively with others in an antagonistic situation; using appropriate interpersonal styles and methods to reduce tension or conflict between two or more people. Addresses conflicts by focusing on the issues at hand to develop effective solutions when disputes or disagreements occur; helps others resolve conflicts by providing impartial mediation when needed.
7. Problem Solving: Uses issue identification, data relation and comparison, pattern recognition and information gathering to create analyses and make recommendations.