Revenue Cycle Manager

FPO Prior Authorization Unit

Full Time

84240BR

Job Summary

Under the direction of the Director of the FPRMO, the Revenue Cycle Manager aka Central Authorization Unit Manager "Manager"will be responsible for setting up a Prior Authorization unit covering authorizations across the Faculty Practice Operations & Network Operations Enterprise. The Manager will be responsible for the setup and daily management of a unit devoted to securing prior authorizations for all clinical categories, including new and follow-up visits and diagnostic and procedural services. The Manager will also need to cover other revenue cycle functions for the healthcare enterprise, including Apex work queue management, reporting, and support. Services are provided in various environments, such as ambulatory care clinics, surgery centers, OB/GYN, and radiology services. Functions are provided in concert with clinical and business departments across the organization to ensure efficient patient flow and maximize revenue collection. Works closely with FPO Contact Center, Clinical Practices, Network Affiliates Contracting, and Revenue Cycle departments to maintain payer requirements and analyze and resolve denials. Other duties include managing supervisors, team leads, and authorization team members to secure authorizations, precise claim edits, and address RFIs promptly as measured by key performance indicators, including "days requested out," "days secured," and reduction of denial net losses. The Manager will enforce consistent and equitable productivity standards for unit members, manage authorization work queue setup and maintenance rules, and create "practice onboarding" processes for moving work and FTEs from existing decentralized units to this centralized unit. The Manager will collaborate and system-wide policies, craft unit guidelines for workflows and training, and direct subordinates to manage utilizing these established guidelines, procedures, and policies.

The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. The annual salary range for this position is $118,300-$268,900, with a target entry point of $184,350. To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

Department Description

Central Authorization Unit within Faculty Practice Revenue Management Operations will be responsible for prior
authorizations securitization, reduction of denied services and timely follow up on pending authorizations related to
various clinical services performed by the providers who are a part of UCSF Health Faculty Practice Operations and
Network Business units.

Required Qualifications

• Bachelor's degree in Health Administration or four years of applicable/relevant experience.
• Three or more years of relevant experience: Revenue cycle management including authorization securitization, demonstrated leadership and managerial skills, with the ability to create and maintain a goal-oriented climate of teamwork and cooperation across departments for practical problem-solving, conflict resolution, support for organizational values, and consistent achievement of targets and objectives.
• Knowledge of healthcare revenue cycle operations, concepts, and policies and their impact throughout the organization, with an in-depth understanding of related functions and issues, including coding, registration, billing, reimbursements, aging accounts, contractual adjustments, and charge capture.
• Strong project management skills with the ability to organize, manage multiple priorities, meet deadlines, and delegate assignments efficiently.
• Strong critical-thinking, project-management, and problem-solving skills, with the ability to troubleshoot, analyze, and interpret complex data and systems to identify problems and implement solutions quickly.
• The ability to work effectively with leadership to establish operational goals and provide technological upgrades, tools, and systems to maximize revenues.
• Excellent written, verbal, and interpersonal communication skills.
• The ability to prepare and present reports and convey complex information and instructions concisely and precisely.
• The ability to cultivate a strong commitment to quality, teamwork, collaborative problem-solving, and achieving objectives.
• Knowledge of metrics, analytics, and data synthesis in healthcare revenue cycle management and their use to identify trends, produce reliable forecasts and projections, and create reports, dashboards, and presentations.
• Knowledge of all relevant information technology, including systems, tools, applications, processes, and methodologies.
• The ability to work onsite in our Emeryville office when required.

Preferred Qualifications

• Certified Professional Coding

About UCSF

At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.

Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu

Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Organization

Health

Job Code and Payroll Title

006618 REVENUE CYCLE HC MGR 1

Job Category

Accounting / Finance, Financial

Bargaining Unit

99 - Policy-Covered (No Bargaining Unit)

Employee Class

Career

Percentage

100%

Location

Emeryville, CA

Campus

Emeryville

Work Style

Hybrid

Shift

Days

Shift Length

8 Hours

Additional Shift Details

M-F