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Director of Prebill Denial Unit in Nashville at Parallon

Date Posted: 2/7/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Nashville
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    2/7/2019

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.


We are a wholly owned subsidiary of HCA, a Fortune 100 company with more than 200,000 employees and one of the nation's leading providers of healthcare services, operating over 170 locally managed hospitals and over 100 freestanding surgery centers in 20 states and the United Kingdom. HCA has been named one of the world's most ethical companies for eight years in a row. At HCA, we are driven by a single goal: the care and improvement of human life.
 
Job Summary

This director level role provides leadership in developing and executing strategic initiatives related to centralized managed care notification and authorization, including the development of standard processes and policies, and assurance the initiatives meet company and regulatory requirements. This role will also provide management and corporate oversight related to all operational aspects of a centralized utilization review unit responsible for correct patient status and authorization.  In this position you will:


  • Work with Prebill Directors and other Parallon Management Team Members at the Shared Service Centers (SSC) to implement and monitor key executive leadership strategies impacting the functional areas within the SSC Prebill areas of responsibility
  • Work with HCA Corporate Case Management on standard utilization review process
  • Maintain strong technical Corporate Subject Matter Expertise (SME) in key functional areas.  Work with other SMEs to ensure collaboration across business lines
  • Partner with data analytics teams to devise innovative solutions for inventory management and additional denial reduction opportunities
  • Monitor SSC budget and variance analysis for the Prebill Denial Units
  • Maintain current industry knowledge to ensure the unit processes are industry leaders
  • Oversight and management of technology solutions supporting operational areas of responsibility
  • Assist with the management of facility concerns and escalations as needed
  • Ensure that operational areas are meeting the needs of internal and external customers, the department and the Company
  • Provide strategic leadership regarding education, policies and procedures




Job Requirements

Education and Experience
  • Bachelor’s Degree in Business or related field required.  If a desired applicant does not have a Bachelor's Degree the requirement can be waived IF they are currently in a Bachelor Degree program. 
  • 7 years revenue cycle operational experience preferred
  • Payor notification and authorization experience and/or payor denial experience preferred
  • Strong Data Analytics knowledge preferred
  • Preferred but not required: MBA, Certification in Case Management, Nursing, Utilization Review,  Interqual Knowledge 

 

 
Benefits of working at Parallon
Our benefits package allows you to select the options that best meet the needs of you and your family. Benefits include 401k with a company match, paid time off, medical, dental, vision, flex spending for both health and day care, life insurance, disability, tuition reimbursement and student loan repayment, employee discount program, employee stock purchase program.
 
We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
 
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