Care Navigator Manager (Certified Medical Billing & Coder)

Position Summary:

Care Navigator Manager

Position Summary:

The Care Navigator Manager is primarily responsible for providing leadership through guidance, motivation, coaching, skill development, medical billing knowledge, and performance management. This candidate will implement and communicate operational vision for the assigned team and monitor progress towards agreed upon IQVIA and Client performance expectations.  Ensures the proper completion of all daily tasks in a timely fashion while ensuring compliance with all standard operating procedures.  The Care Navigator Manager must maintain a diverse and motivated team using the employee relations policies. This is a hybrid position based out of Bridgewater, NJ or Durham, NC.

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned.

Primary Responsibilities:

• Act as primary resource of program knowledge to the Care Navigator team
• Provide claims and medical billing information by answering questions, aiding customers, providers, and fellow employees.
• Ensure employee training and quality of work meets or exceeds expectations.
• Plan, review and optimize workflows within Care Navigator team.
• Collaborate with other departments and the Client to ensure business needs are met.
• Monitor telephony platform metrics for assigned personnel.
• Monitors compliance regarding proper and appropriate use of approved client resources.
• Answer staff and customer questions and recommend corrective services to address customer complaints.
• Recruit, interview, and recommend Care Navigator candidates.
• Be responsible for 180 day and annual performance review, resolving personnel issues, discipline, and termination of assigned personnel.
• Analyze data and make recommendations for enhancements to processes, and procedures
• Schedule and delegate workload amongst team members, as needed to accommodate vacation and illness.
• Manage your team member’s workloads to effectively manage cost and reduce overtime.
• Audit and verify team members work to ensure information accuracy.
• Work cross-functionally with dedicated QA & Trainers for optimal training, onboarding, and continuous development of staff.
• Monitors timekeeping and attendance for IQVIA employees.
• Any additional duties as assigned by Regional Managers or Project Lead.

Required Qualifications:

• Bachelor’s degree preferred.
• Must be Medical Billing and Coding Certified.
• Patient support program experience preferred (2 years).
• Previous management experience (2 years) preferred.
• Management experience of telephonic and/or call center teams required.
• Proven success working with or within patient-centric organizations or other patient health-related, community focused organizations providing services to targeted populations.
• Experience using person-centered thinking/planning or motivational interviewing a plus.
• Ability to apply emotional intelligence and empathetic listening with all interactions.
• Must be able to manage multiple tasks and have excellent organizational skills.
• Ability to examine business environment and develop/execute in response to program opportunities.
• Candidate should have a working knowledge of the market including trends and issues as they relate to customer service and virtual communications.
• Ability to lead and drive for results in cross-functional teams. Strong planning and prioritization skills.
• Strong and effective presentation skills; excellent communications skills – both written and verbal.
• Drive and enthusiasm.
• Exceptional interpersonal skills and the ability to build and inspire support for initiatives.
• Ability to build and maintain relationships with third parties using strong collaborative and communication skills.
• Fully competent in MS Office (Word, Excel, PowerPoint).

Preferred Qualifications:

• Experience verifying insurance eligibility and coverage including but not limited to benefits, pre-certification and referrals, and reimbursement.

Professional Competencies:

• Business Skills and Knowledge
  • General Management: Demonstrate analytic and problem-solving skills and understand the impact of individual decisions on other parts of the organization and the environment.
  • Risk management: Knowledge of liability and compliance regulation, the ability to employ strategies to mitigate risk, avoid malpractice and plan for disasters.
  • Quality improvement:   Application of techniques that continually improve the quality of care provided, patient safety, organizational performance, and the financial health of the organization.
• Knowledge of the Health Care Environment
  • Health Care Systems and Organizations: Demonstrate an understanding of how the various components of the health care system is organized and financed, and how they interact to deliver medical and health care.
  • The Patient’s Perspective:  Understand the patient experience, demonstrate a commitment to patients’ rights and responsibilities, and ensure that the organization provides a safe environment for patients and their families.
• Communication and Relationship Management
  • Relationship Management: The ability to build and maintain relationships with internal as well as external stakeholders that are anchored in trust and where decision-making is shared.
  • Communication Skills: Be able to utilize verbal, written and presentation skills to communicate an organization’s mission, vision, values and priorities to diverse audiences.
• Leadership
  • The ability to inspire individual and organizational excellence, create and attain a shared vision and successfully manage change to attain the organization’s strategic ends and successful performance.
• Professionalism
  • The ability to align personal and organizational conduct with ethical and professional standards that include a responsibility to the patient and community, a service orientation, and a commitment to lifelong learning and improvement.

#LI-CES

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

The potential base pay range for this role is 75,000 annually. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.