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Manager of HMO Account Services
AVANTE Orlando, FL
$83k-107k (estimate)
Full Time | Business Services 2 Months Ago
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AVANTE is Hiring a Manager of HMO Account Services Near Orlando, FL

JOB TITLE: Manager of HMO Account Services

SUPERVISOR: Vice President of Revenue Cycle Management
DEPARTMENT: Accounts Receivable

Purpose:

The Manager of HMO Account Services oversees the development and management of various care management programs that support Avante's health strategy. The position works in partnership with management staff who perform utilization management. Collaborates with clinical and operational leadership to develop and implement innovative care management operations and solutions. Collaborate with contract services to ensure the facilities are aware of the most updated billing requirements. Employs direct communication, site visits, information distribution, staff education and problem solving to develop relationships, and obtain feedback. Coordinates with Avante's leadership regarding community resources and specialty services.

Qualifications:

  • Must meet the additional educational and experience requirements outlined below
  • Experience in working in management-level positions in health care industry
  • Must be able to read, write, write, speak, and understand the English language
  • Must be at least eighteen (18) years of age
  • Must be a supportive team member, contribute to and be an example of teamwork and team concept.
  • Must possess the ability to make independent decisions when circumstances

warrant such action

  • Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general public
  • Must be able to always work in a constant state of alertness and in a safe manner

EssentialJobFunctions:Responsibilities include but are not limited to the following:

  • Assists in developing an innovative and robust case management program, as well as creating Case Management education and policies and procedures to enhance patient outcomes while collaborating with IDT
  • Uses data to establish metrics, monitor utilization trends and reports on the overall UR process
  • Update AIR billing systems as required including Managed Care guides and contract information
  • Timely and effective disposition of claims in accordance with the available coverage, including supplements to contracts, (pharmacy, transportation, equipment, etc.) and applicable procedures, laws, and regulations.
  • Critical Thinking/Problem. solving
  • Ability to work. in a constant state of alertness and in a safe manner at all times.
  • Performs all other duties as assigned.
  • While performing the duties of this job, the employee is required to stand; walk; sit; use hands to finger, handle or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; lift and/or move equipment (generally up to 25 pounds); grasp; stoop, bend, kneel or crawl; talk or hear; distinguish smells, tastes and temperatures; remain calm under stress.
  • Works in a climate-controlled and well-lighted environment, and primarily works in an office and throughout the facility daily, as well as the corporate office.
  • Is subject to interruptions and noise on a daily basis.
  • May be subject to the handling of and exposure to hazardous chemicals and materials while at Avante facilities and is trained in Avante's safety program and related protocols.
  • Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
  • Always being able to work in a constant state of alertness and in a safe manner.
  • Works beyond normal working hours as necessary, including weekends and holidays.

Education and Experience:

  • Must possess, at a minimum, an associate degree from an accredited school, college, or University
  • Five (S) to Eight (8) years' experience working in management-level positions in the health care industry
  • Case Management, Health Plan with Medicare/Medicaid experience preferred.

Avante provides equal employment opportunities (EEO) to all employees and applicants for employmentwithout regard to race, color, religion, sex, Veterans' status, national origin, gender identity or expression,age, sexual orientation, disability, gender, genetic information, or any other category protected by law. Inaddition to federal requirements, .Avante complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies toall terms and conditions of employment, including recruiting, hiring, placement, promotion, termination,layoff,recall,transfer,leavesofabsence,compensation,andtraining.

Avante expressly prohibits any form of workplace harassment based on race, color, religion, sex, gender,sexual orientation, gender identityor expression,national origin, age, genetic information, disability,Veterans' status, or any other category protected by law. Improper interference with the ability of Avante'semployeestoperformtheir Jobdutiesmayresultindiscipline, uptoandincluding,discharge.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Business Services

SALARY

$83k-107k (estimate)

POST DATE

01/27/2023

EXPIRATION DATE

02/13/2023

WEBSITE

avanteconsulting.com.br

HEADQUARTERS

SINGAPORE, CENTRAL

SIZE

50 - 100

FOUNDED

2016

REVENUE

<$5M

INDUSTRY

Business Services

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