Eligibility and Enrollment Services Manager - Conifer Health Solutions

JOB SUMMARY

Responsible for providing guidance and support to the EES supervisory staff, including adherance to Conifer Standards of Conduct and supervision of all hiring, training and personnel actions. Ensures that Eligibility and Enrollment Services (EES) collection and assignment goals and SLA’s are met. Responsible for responding to and serving as subject matter expert for eligibility operations and service line questions for clients. Promotes relationships with clients and governmental agencies with which the department interacts.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Reviews inventory for quality assurance. Works with supervisors to ensure all areas of region are meeting expectations for eligibility, collections/assignments.
• Acts as liaison for facility CFOs and BOMs, conducts presentations and provides updated reports, ensuring customer satisfaction.
• Monitors operational/automation issues for all facilities within market/ region.
• Writes and implements policy and procedural changes as needed.
• Completes weekly/monthly reporting processes to corporate and individual facilities.
• Ensures regional adherence to Conifer Standards of Conduct.

FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense):

• Responsible for ensuring operational expense does not exceed budget (Expense budget range for market/region $1M to $3M). Responsible for annual collection amounts in the range of $5M to $20M.
• Scope: Multiple locations in a market, or multiple small markets

SUPERVISORY RESPONSIBILITIES

This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

• Direct Reports (titles) Supv, EES; Clerical Support, EES; or Rep, EES Appeals
• Indirect Reports (titles) Rep, Patient Advocates and Leads; Rep, EES Financial Counseling and Leads

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Intermediate knowledge of hospital Patient Access & A/R processes
• Advanced knowledge of government programs eligibility and reimbursement, Charity care guidelines and billing processes
• Intermediate Microsoft Office (Word and Excel)
• Intermediate writing skills
• Ability to prioritize and manage multiple tasks with efficiency

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience required to perform the job.

• 4 year college degree in Healthcare Administration, Business or related area or equivalent experience
• 5 – 7 years experience in Healthcare Administration or Business Office
• 2 – 3 years supervisory experience preferred

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to sit and work at a computer terminal for extended periods of time
• Must be able to walk through a hospital environment, including across broad campus settings and Emergency Department environments, and visit patients at bedside
• Ability to travel

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Both Hospital and Office facilities, in direct contact with Patients and Staff

OTHER

• Must be able to travel overnight

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.