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HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment.
Working with colleagues who love what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.
Director, Account Management
Reporting directly to the Assistant Vice President, Account Management, the Director of Account Management will be primarily responsible for the identification, escalation and resolution of hospital or PHO physician-related payor issues. These include, but are not limited to contract or enrollment issues impacting billing/reimbursement, administrative issues impacting operations, and communication with key stakeholders. This position provides oversight to Managed Care Coordinators and serves as a liaison to the hospital and PHO Payor Contracting teams.
- Oversees compliance of managed care companies and payment rules with negotiated contracts.
- Works closely with other members of the Account Management team, CCS team (i.e. UM/clinical denials team) and Patient Financial Services and/or the Central Billing Office to identify trends and opportunities in outstanding Accounts Receivables for both the PHO and hospital entities.
- Responsible for ensuring pertinent reports and updates (i.e. A/R, denials, etc.) are disseminated to departmental staff. This includes working with Patient Financial Services and other departments on the implementation and maintenance of departmental dashboard
- Escalates issues as necessary to mid-level payer contacts for resolution as well as HSS contracting team. Recommends escalation as appropriate to senior management.
- Provides feedback on trends/patterned issues to Contracting team to aid in negotiation and implementation of fee-for-service and value-based payor contracts across HSS and PHO
- Assesses contract administrative terms and advises leadership accordingly on measures of contract performance
- Ensures key stakeholders are communicated to on contractual obligations, emerging trends stemming from contract performance, payor/policy changes, and other related topics
- Maintains up to date knowledge on the healthcare market and timely initiatives
- Advise on/implement departmental policies, protocols and systems (i.e. Salesforce) to enhance efficiency and effectiveness of workflows
- Possess strong leadership skills and demonstrate capability to inspire staff to pursue excellence in goals and productivity; capable of coaching and improving staff in need of professional development. Places high priority on overall team performance.
- Additional responsibilities as required to accomplish departmental goals.