Enterprise Director Authorization Services

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Directs patient pre-certification processes performed in the WVU Medicine Centralized Authorization team servicing all WVUHS hospital facilities. Responsible for the accuracy and consistency of hospital pre-certification and insurance verification for the health system. Develops and controls all tasks necessary to ensure all activities are completed on-time, including building relationships with internal and external clients throughout WVU Medicine. Utilizes internal resources and analytical skills to make decisions in fast-paced, fluid environment. Accountable for making strategic decisions guided by organizational issues, trends, and business implications, keeping in mind that decision may have regional/local implications. Recognizes cross-function interdependencies of decision. May challenge decisions where precedents have been set and communicates rationale with stakeholders to gain consensus. Supports the success of a high-performing patient financial access department by helping to champion and drive long term success, achieving results comparable to national best practices. Achieves highest standard of customer service while maintaining consistency and representing the WVU Medicine brand to our patients.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

 Bachelor’s Degree within 90 days of hire

 OR

4 years relevant experience

EXPERIENCE:

1. 5 years management experience required

2. 5 years of experience inpatient financial access services including registration, scheduling, pre-certification, and/or financial counseling.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s Degree in Accounting, Finance, or Business

2. Master’s Degree, CPA, Certified Healthcare Financial Professional (CHFP) of HFMA

EXPERIENCE:

1. Experience developing standards, processes, policies and procedures for a diverse organization

2. Record of success managing complex projects with multiple, diverse stakeholders.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Directs Scheduling and Order Management Functions: Leads efficient local scheduling and order entry functions throughout the WVU Medicine Hospitals.   System Director will establish standard processes and procedures where possible to streamline functions for the system entities.  Work with WVU Medicine Information Technology to ensure efficient and effective workflows.   Continually monitor productivity and quality through standard processes and scorecards.

2.  Directs Pre-Certification Functions:   Workflows for pre-certification varies throughout the health system.   Enterprise Director will establish standard processes and procedures where possible to streamline functions for the system entities.  Will work closely with information technology team for appropriate EPIC modules (Optime, Cupid, Cadence, etc.) to aid in the design of efficient and effective workflows.  Monitors processes for failures and continually refines to ensure staff is supported and productivity and quality standards are met.  Work closely with Directors in Patient Financial Services and Patient Access to communicate and solve any denial issues arising due to these functions.  Continually monitor productivity and quality through standard processes and scorecards.  Acts as the primary resource for implementation of automations that assist staff productivity and accuracy.

3. Guides Departmental Goals and Achievement: Functions as primary resource for all Patient Financial Access decisions related to pre-service clearance with information technology, patient financial services, medical records, utilization management, ancillary revenue departments, etc. for the West Virginia University Health System.  Ensures close cooperation, planning and strategic alliances with all areas affecting patient financial outcomes.  Plans and sets goals with all related areas to ensure decisions are optimal for organizational goals and consistent with missions, administrative philosophy and guidelines.   Ensures physician relationships are developed and maintained to reflect collaborative environments. Adheres to and ensures all compliance requirements are m