Enrollment & Billing Manager jobs in Denver, CO

Description

Manager - Program Enrollment

STRIDE Community Health Center is a 501(c)(3) Federally Qualified Health Center (FQHC) with a 30-year history of providing primary care and other health-related services in a community-based setting. Established in 1989 in response to the primary health care needs of the medically indigent population in suburban Denver, STRIDE Community Health Center has one of the largest population base of any FQHC in Colorado and provides primary care, dental, pharmacy, behavioral health, health education, care coordination, patient navigation, pharmacy, and outreach and enrollment services in accordance with its mission.

General Purpose: STRIDE offers a wide variety of programs and services to community members and patients including programs such as Medicaid, Child Health Plan , CICP, STRIDE Discount and Colorado Connect for Health. This position performs professional management functions associated with financial screening activities. Responsible for planning, organizing, and directing financial screening functions and management. Conducts internal audits. Ensures that all policies and guidelines are followed. Develops policy and procedures, outreach/in-reach strategies and provides overall implementation of programs and services at STRIDE. Adheres to the spirit of the STRIDE mission statement while performing assigned duties. Demonstrates thoughtfulness and consideration of each employee. Ensures that all patients are screened for eligibility, educated about and enrolled in all STRIDE programs and services.

We Offer $74,394-$96,712 based on experience including:

• Medical, Dental, and Optional Vision Insurance.
• Paid-Time-Off (PTO).
• Company Paid Life Insurance.
• A 401K retirement savings plan & match!
• Flexible Spending Account (FSA) and Dependent Care options.
• And more!

Essential Duties/Responsibilities:

General Leadership and Management

• Create and maintain a positive, recognition-based, and fun work environment for staff that results in teamwork within the Outreach and Enrollment department and productive collaboration with other departments within the organization.
• Supervise department personnel. This includes coaching, training, scheduling, evaluating, hiring and terminating staff.
• Monitor department performance in relation to established goals, take corrective action when needed, and implement improvements.
• Perform monthly audits of established Outreach and Enrollment Specialists and audits on all applications for new hires during initial period.
• Oversee the operations of the Outreach and Enrollment Specialists.
• Provide financial screening duties on an as needed basis.

Operational Objectives

• Oversee the Outreach and Enrollment Specialist process in order to maximize the number of patients financially screened by optimizing schedules and penetration by site.
• Monitor Self-Pay and Medicaid Pending report.
• Contributes to the effective design, implementation and sustainability of new payer agreements across STRIDE programs.
• Develop workflows to support Revenue Cycle processes regarding patient coverages, for all Revenue Cycle roles.
• Participates in the effective design of the Sliding Fee Discount Schedule.
• Uses data reporting to inform Revenue Cycle leadership of trends regarding patient coverages.

Internal Reporting

• Design, development and dissemination of internal operational reports to key internal stakeholders

External Reporting & Compliance

• Participate in the creation, completion, validation and submission of assigned external reporting requirements including, but not limited to:

o CAAS Reports

o CICP Quarterly and Final Reports

o Medicaid Cost Report

o Medicare Cost Report

• Primary Care Fund Reports
• RWG Reports
• SDP Reports

• Ensure full compliance with state and federal regulations regarding financial screening practices.
• Actively participate in strategic discussions and decisions affecting STRIDE’s future ability to screen patients.

Continuous Improvement Projects

• Seeking opportunities to improve Enrollment Screening processes such as those to:

o Increase productivity

o Save money

o Reduce errors

• Become and remain well versed in all payers including exchange/marketplace products.
• Develop and implement enrollment training materials, presentations, training guides, policies and procedures.
• Collect data, prepare reports, compile and analyze statistics.
• Maintains current knowledge and skills of all computer programs being used in the clinic sites.

Staff Recruitment and Development

• Provide timely quarterly audits to Outreach and Enrollment staff in order to increase staff experience, expertise and drive results.
• Provide coaching and mentoring to Outreach and Enrollment staff.

Communication and Partnerships

• Partner with all Revenue Cycle impacting departments to ensure consistent communication and oversight of Outreach and Enrollment Specialists.
• Ensure compliance with internal STRIDE policies and procedures and works with all staff in assigned sites to ensure compliance with policies and procedures regarding program enrollment.
• Attend relevant and required meetings (both internal and external) stakeholder meetings, forums, coalition meetings, trainings and community events.
• Partner with Outreach and Enrollment Program Specialists to execute FQHC initiatives.
• Partner with Customer Care Center in the scheduling of enrollment visits and make recommendations for shifts in the schedule based on community demand.
• Partner with Patient Accounts in working Medicaid Pending reports and Self Pay reports.

Other Duties/Responsibilities:

• Maintains a safe work environment by remaining informed of and compliant with the clinic’s safety policies, and in particular by application of safe practices in area of own responsibility.
• Compliance:

o Knowledgeable of and compliant with laws and regulations governing area of responsibility.

o Responsible for reporting any potentially non-compliant conduct.

o Cooperates fully with our Compliance Officer in upholding our Compliance Plan.

• The expectation of significant involvement and participation in the following:

• Serve as support to STRIDE staff including Front Desk.

• Maintain a safe work environment.

• Perform other duties and responsibilities as required.

Qualifications

Job Qualifications:

Knowledge, skill and ability

• Skill in leadership, management and direct supervision of employees including administering disciplinary action and performance evaluations.
• Ability to work independently and organize work in a manner that ensures accuracy and efficiency.
• Ability to write and work from procedure manuals.
• Excellent oral and written communication skills, including presenting and speaking in public settings.
• Ability to demonstrate the capability to effectively and sensitively respond to the needs and concerns of the full range of STRIDE’s diverse patient population.
• Customer service skills, including working with people in one-on-one settings and group settings and the ability to diffuse upset patients.
• Ability to explain and summarize detailed concepts like Medicaid Enrollment Process or Essential Health Benefits in a way that the general population can understand.
• Ability to create a department atmosphere which encourages motivation, innovation and high performance.
• Skill in exercising initiative, judgment, problem-solving and data driven decision-making.
• Ability to delegate responsibility and authority to staff.
• Sensitivity to low income and ethnic minority community.

Education: Bachelor’s degree in Business Administration, Health Administration or similar field required. ***Experience may be substituted for higher education.

Experience: Three or more years of experience working with programs and services intended for low-income, underserved populations. At least two years of experience in management, leadership and direct supervision. Knowledge of Medicaid, Child Health Plan and insurance programs required, experience working with grant programs preferred.

Material and equipment directly used: Computer, Centricity, CBMS, PEAK, Connect for Health Colorado, , data and data-based development and resources, printer, multi-line telephone systems, fax machine, copy machine, calculator, and all Microsoft Office products including Outlook, Excel, other financial software and the internet.

Working environment/physical activities: Office environment within a clinical setting, ability to travel to/from various clinics in own vehicle as required, ability to travel to/from various offsite organizational and industry-related meetings, periodic weekend or evening work is expected, moves/transports objects up to 25 lbs occasionally, communicates information to others and discerns/analyzes information from others to assist in decision making.

Join Us. Together We Improve lives.

STRIDE conducts a background check, including criminal history, education, license and certification.

STRIDE recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our organization. STRIDE is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, genetic information or veteran status. STRIDE does not discriminate against any "qualified applicant with a disability" as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

A successful candidate will live STRIDE ICARE values:

Integrity doing the right thing even when no one is watching.

Compassion meeting the patient where they're at with empathy.

Accountability doing what we say were going to do.

Respect showing attention to human dignity.

Excellence having a growth mindset; striving to learn more and practice continuous improvement.

In an aim to help keep our patients, staff, and communities safe, STRIDE requires that all hired employees be fully COVID-19 vaccinated and to obtain an annual flu shot. STRIDE CHC employees are also required to be screened for tuberculosis and to complete a PPD test.