Manager, Revenue Operations (ROPS)

About the role

This position manages the billing, third party insurance collections, and cash posting activities for multiple teams responsible for reimbursement operations and accounts receivable (A/R) for DaVita Rx pharmacies in accordance with company policies and in compliance with federal, state, and SOX regulations.

Supervisory Responsibilities

• Yes

Essential Duties And Responsibilities

• Manage work of teammates and participate as necessary to ensure goals are met within established policies and procedures
• Manage the Third-Party Billing and Collections team to minimize Third-Party A/R
• Ensure appropriate controls and procedures are in place to guarantee timely and accurate billing and collections practices
• Manage the Cash Posting team to ensure all Third-Party (Insurance) and Patient payments are applied in accordance with company policies
• Complete weekly reconciliation of payments received and posted to meet Cash Controls and SOX compliance requirements
• Ensure patient billing statements are produced accurately and mailed timely each month
• Manage the Medicare Part B Billing team to ensure billing and collecting on Medicare Part B items (as well as resulting secondary billable items) are completed timely, accurately, and in compliance with all laws and regulations
• Review daily, weekly, and monthly key metrics to identify trends or areas of focus
• Maintain confidentiality of all patient, teammate, and company information in accordance with HIPAA regulations and DaVita policies
• Collaborate closely and in conjunction with Director with other DaVita Rx departments and teammates as well as with DaVita facility teammates as necessary for the overall benefit of patients and achievement of mutual goals
• Maintain current knowledge of all laws, regulations, and changes that may impact the Reimbursement Operations team
• Travel Required: up to 10%

Teammate Management

• Provide leadership to direct reports
• Help direct reports overcome any organizational obstacles encountered during projects
• Manage all teammate employment activity such as hiring, promoting, job performance, evaluations, retention, and disciplinary actions with appropriate approvals as required
• Address teammate relations issues appropriately and escalate as necessary
• Develop, document and implement action plans, as appropriate, to address deficiencies identified while reviewing teammates’ work product
• Know, understand, implement, follow, and communicate to teammates all DaVita employment policies and procedures, awards, and other opportunities within company and foster a positive work environment
• Ensure all DaVita employment processes are completed timely and in compliance with DaVita policy and any applicable laws including but not limited to ePCNs, Performance Development Reviews, teammate personnel file maintained, etc.
• Facilitate teammate development (PDRs, coaching, mentoring, DaVita training, outside training); collaborate with direct reports to create professional development goals
• Provide consistent, visible, and timely communication to team on team goals, objectives, progress toward goals and enable teammates to meet job responsibilities successfully
• Maintain familiarity with and communicate to teammates DaVita programs impacting teammates (including but not limited to: Triple Crown, We Are Here, Tuition Reimbursement, Foundations, etc.)
• Ensure new teammates receive the appropriate training, tools, system access, and support to effectively complete their duties, understand department, computer systems, their role, and company policies, procedures and compliance standards
• Determine staffing plans that promote the most effective use of all teammates; provide adequate staffing levels and phone coverage for all hours of operations; ensure coverage during teammate absences
• Know and understand basic wage and hour laws, federal, state and local laws and regulations, Medicare, and legislation affecting employment
• Review and approve time cards of hourly direct reports for bi-weekly payroll
• Track overtime, attendance, and PTO
• Develop and conduct educational programs to keep teammates up-to-date on DaVita policies, new laws and regulations impacting work, and other information necessary to maintain teammates’ knowledge of department processes and goals
• Know, understand, follow, and implement DaVita safety and security policies and procedures

Qualifications

• Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required.
• Bachelor’s degree in Business, Accounting, or related field required
• Minimum of five (5) years experience managing Accounts Receivable (A/R) in a healthcare provider setting
• Demonstrated, detailed knowledge of and managerial oversight for Medicare Part D, Medicare Part B, Medicaid and Commercial Insurance billing and collections activities for plans across multiple states required
• Advanced computer skills and proficiency in MS Word, Excel, Access, and Visio required; intermediate proficiency with Outlook required; basic proficiency in PowerPoint preferred; prior experience using electronic billing system strongly required