What are the responsibilities and job description for the Senior Manager of Financial Assistance position at Keystone Advisors LLC?
Keystone Advisors is an independent Certified Public Accounting firm providing Audit, Accounting, and Advisory Services in the areas of financial and administrative management, organizational and business improvement, program management support, budget support, financial analytical services and reconciliation, technology management and staff augmentation in Chicago, Washington, DC, Alexandria, VA, and other metropolitan areas.
Keystone is looking for a Senior Manager of Financial Assistance to join our team supporting one of our healthcare clients in the Illinois Medical Center.
The Senior Manager of Financial Assistance is responsible for the administration and management of all patient’s financial assistance programs, including CareLink, in an efficient, appropriate manner for patients. Facilitates the administration of the program in accordance with managed care best practices while working with CCH departments that support program components such as eligibility screening, outreach for potential care coordination enrollment or primary care physician linkages. Provides operational expertise and interfaces effectively with community-based organizations and county commissions.
Job Duties:
Keystone is looking for a Senior Manager of Financial Assistance to join our team supporting one of our healthcare clients in the Illinois Medical Center.
The Senior Manager of Financial Assistance is responsible for the administration and management of all patient’s financial assistance programs, including CareLink, in an efficient, appropriate manner for patients. Facilitates the administration of the program in accordance with managed care best practices while working with CCH departments that support program components such as eligibility screening, outreach for potential care coordination enrollment or primary care physician linkages. Provides operational expertise and interfaces effectively with community-based organizations and county commissions.
Job Duties:
- Manages the day-to-day activity of the patient financial assistance programs which includes responding to inquiries, educating staff, collaborating with stakeholders, preparing reports, and attending meetings
- Develops workflows and job aids, i.e. resource list, telephone list, process criteria, policy related information
- Collaborates and communications with other departments on related projects and inter- departmental operations issues
- Documents workflows and policy and procedures
- Reviews public health data analyzing state-wide trends and health information from public and private sources to arrive at a description of the population from the perspective of size; age and sex; disease burden; utilization patterns, preventive service use and medication experience
- Completes operational and financial analysis for review
- Collaborates with all stakeholders to identify opportunities to improve quality and control cost. Creates a plan and measures the impact of the agreed upon interventions
- Provides training and job aids for staff who are supporting the patient financial assistances programs
- Develops processes and protocols to develop core competencies of an effective organization managing care utilized by financial assistance program members such as understanding and mitigating risk, member outreach, care coordination, financial and utilization review, and network management
- Leverages CCH technology and to best serve patients, i.e. portal access, e-Consult, etc.
- Prepares and submits management and regulatory reports including dashboard for senior leadership, as required
- Performs other duties as needed
Minimum Qualifications
- High School Diploma or GED equivalent with seven (7) years’ of experience with Medicare, Medicaid, and/or Commercial insurance products OR Associates degree from an accredited college or university with five (5) of experience with Medicare, Medicaid, and/or Commercial insurance products OR Bachelor’s degree from an accredited college or university with three (3) years of experience with Medicare, Medicaid, and/or Commercial insurance products
- Two (2) years of work experience interfacing with diverse stakeholders, i.e., community advocates, physicians, and community members
- One (1) year work experience in analyzing financial and administrative data
- Intermediate knowledge of Microsoft (Word, Excel, Access, PowerPoint, Outlook)
Preferred Qualifications
- Bachelor’s degree in Business, Healthcare Administration, or Public Health from an accredited college or university
- Bilingual
- Experience and advanced knowledge of contractual, administrative, health insurance and operational issues related to managed care organizations, physician groups, hospitals, and health insurance benefit plan designs
- Previous experience with databases and contract modeling
Knowledge, Skills, Abilities and Other Characteristics
- Knowledge of the Illinois Managed Care Model including IPA's, Medical Groups, MSO's, Health Systems and Health Plans, DOFR, Medicare and Commercial Fee Schedules.
- Knowledge and understanding of contracting including financial analysis, credentialing, legal review, implementation, preferred, CAP, Value-base and utilization data.
- Knowledge of network management including grievance resolution, authorizations and resolving complex member-level issues.
- Excellent communication, presentation, and negotiation skills.
- Ability to work with and influence others including customer service, revenue cycle, staff, and key strategic partners.
- Ability to planning, design, development, implementation and evaluate policies and procedures.
- Ability to prioritize work and ensure all compliance elements are met, aligns program operations to governmental sponsored programs.
- Ability to maintain confidentiality of all patient information, as per HIPAA guidelines.
- Ability to maintain or exceeds all standards, as per the approved Plan accreditation bodies.
- Ability to maintain a full comprehensive understanding of the covered benefits, coding and reimbursement policies and contracts.
- Ability to develop a network that supports program objectives.
- Ability to work collaboratively to achieve project goals.
- Competitive Salary
- Paid Time Off
- Health, Vision & Dental Insurance
- Health Savings Account (HSA)
- Flexible Spending Account (FSA)
- Short- & Long-Term Disability
- 401(K)
- Life Insurance
