Mission StatementThe mission of The University of Texas MDAnderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.SummaryThe Supervisor of the Financial Clearance Center is responsible for creating a positive patient experience by providing direct supervisory oversight of the Patient Access Associates and Patient Access Coordinators and the day-to-day operations relating to financial clearance activities. This includes proper management and adherence to department policies and procedures related to the verification of eligibility/benefits, pre-authorization, and financial counseling. The Supervisor will serve as a clinical resource for the FCC using such knowledge to assist with facilitating pre-auth request and driving meaningful discussions with the payors. Assist the Manager with establishing and delivering ongoing education and training to new and/or existing staff. The Supervisor is also responsible for the hiring, evaluating and providing ongoing mentoring and feedback to designated staff.Major Work Activities
Supervises and coordinates operational activities related to the timely verification of eligibility and benefits, accurate and efficient pre-authorization of required services
Provides guidance related to available payment options, inquiries regarding cost estimates, requirements related to patient assistance programs and proper financial counseling of patients
Reviews, tracks and manages activities related to designated departmental work queues to ensure timely resolution of patient accounts
Facilitate with obtaining pre-authorization on difficult cases, including cases that require clinical input, interpretation, medical necessity justification and peer to peer engagement
Provides direction and support to FCC staff with interpreting and understanding payor medical coverage policies and uses clinical knowledge to drive meaningful discussions with payors regarding pre-auth request and/or continuity of care needs
Acts as a liaison to assist with maintaining effective relationships and resolving matters, including escalated FCC issues that require interactions directly with Patient Access and/or a health plan, third party vendor, or new/existing patient
Provides ongoing updates and education to staff regarding payor related requirements
Maintains knowledge of systems and processes that impact admissions, verification and other patient access related functions
Assist Manager with developing and revising plans for continuous improvement to ensure the department maintains compliance with established FCC, institutional and required regulatory policies and procedures
Responsible for monitoring daily activity and performance metrics reports to assist with improving process flows and procedures
Required Education:Graduation from an accredited school of professional nursing.Preferred Education:Bachelor of Science in Nursing (BSN).Required Experience:Five years experience in clinical nursing to include one year of experience in utilization review, case management, discharge collaborative planning, Quality Assurance or team lead experience. Preferred degree may substitute for two years clinical nursing experience. Successful completion of the LEADing Self Accelerate program may substitute for one year of required supervisory or management experience.Preferred Experience/Skills:Experienced with insurance and authorization, supervisory experience with leading a team, excellent communication skills.Required Certification/License:Current State of Texas professional nursing license (RN). Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR) certification.Other Requirements:Must pass pre-employment skills test as required and administered by Human Resources.Preferred Certification:American Heart Association Basic Life Support (BLS), ACLS (Advanced Cardiac Life Support) or PALS (Pediatric Advanced Life Support) certification as required by patient care area.It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.htmlAdditional Information
Requisition ID: 170901
Employment Status: Full-Time
Employee Status: Regular
Work Week: Days
Minimum Salary: US Dollar (USD) 98,500
Midpoint Salary: US Dollar (USD) 123,000
Maximum Salary : US Dollar (USD) 147,500
FLSA: exempt and not eligible for overtime pay
Fund Type: Hard
Work Location: Remote (within Texas only)
Pivotal Position: No
Referral Bonus Available?: No
Relocation Assistance Available?: No
Science Jobs: No
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