Vendor Mgr, Authorization Mgt
2 weeks ago
OverviewHours: Monday through Friday, 8am-5pmLocation: Downers Grove, IL (Hybrid)Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our work.Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. We invite you to join us, fulfill your purpose and make your markHolistic benefits designed to help our team members flourish in all aspects of their lives, including: Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider.$5,250 Tuition Reimbursement per year. 40 hours paid volunteer time off. 12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members. 401(k) MatchProfit-sharing program ResponsibilitiesThe Journeys and Adventures that AwaitMonitor vendor performance against service level agreements (SLAs) and key performance indicators (KPIs) to ensure they meet operational and compliance standards. (50%)Implement and oversee quality control systems to monitor the accuracy and timeliness of patient authorizations. (15%)Collaborate with internal teams, such as billing, coding, and patient care, to integrate authorization services smoothly into the overall RCM process. (10%)Identify and resolve issues related to vendor performance and patient authorization processes. (10%)Drive continuous improvement initiatives with vendors to enhance service delivery and patient outcomes. (5%)Develop and maintain strong relationships with external vendors specializing in patient authorization services. (5%)Facilitate regular reviews and audits to ensure adherence to healthcare regulations and standards, including HIPAA. (5%)Prepare and present regular performance reports to senior management, providing insights and recommendations for improvements.Stay updated with changes in healthcare regulations and industry best practices to ensure vendor services remain compliant and effective.Performs other duties as necessary QualificationsMINIMUM KNOWLEDGE, SKILLS, AND ABILITIES Strong understanding of healthcare processes, especially patient authorization and compliance requirements.Excellent negotiation and relationship management skills.Strong analytical and problem-solving abilities.Exceptional communication and interpersonal skills.Proficiency in healthcare IT systems and software.Years of Experience: 5+ yearsLevel of Education: Bachelor's degree in business administration, Healthcare Management, or related field or 10 years or more of experience in Authorization in the Healthcare field for large multi-specialty group practice.Desirable Experience:Experience with electronic health records (EHR) systems-preferably EpicCertified Professional in Healthcare Information and Management Systems (CPHIMS) or related certification.
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Vendor Mgr, Authorization Mgt
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