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Manager, Value-Based Compensation
2 months ago
At Pacific Dental Services, we are committed to fostering a culture of growth and development. As a member of our team, you will have the chance to enhance your skills and gain invaluable experience.
Position Overview:
The primary role of the Manager, Value-Based Compensation is to oversee the daily operations of the Value-Based Compensation team. This team may be organized by region, specialty, or other relevant characteristics. The Manager's key responsibility is to assess the performance, efficiency, and productivity of the team.
This position is crucial in ensuring that data is accurately extracted from medical records to address HEDIS gaps, and that all submitted documentation is precise and complete. Responsibilities include supervising pursuit lists, coding, auditing, and following up on forms.
Key Responsibilities:
- Provide strong leadership, coaching, and mentoring to team members, identifying and implementing opportunities for performance enhancement.
- Guide and support less experienced team members, fostering an environment conducive to knowledge sharing and cross-training.
- Conduct daily activities related to chart preparation and auditing of patient records.
- Investigate discrepancies in CPT and ICD-10 coding to ensure compliance and accuracy in reimbursement.
- Address inquiries from staff and clients regarding value-based processes.
- Prepare and present comprehensive reports on all audits.
- Ensure thorough and accurate documentation.
- Analyze data, evaluate outcomes, and determine optimal solutions to challenges.
- Plan and organize work schedules, assigning specific duties to staff.
- Lead the team to optimize performance on HEDIS measures, communicate challenges, and implement process improvements.
- Establish and maintain effective working relationships with healthcare providers to address and resolve issues related to value-based discrepancies.
- Report regularly to management on achievements, areas for improvement, performance goals, and system effectiveness.
- Ensure adherence to company policies and compliance with state, federal, and other regulatory requirements.
- Develop and conduct impactful training sessions and meetings, showcasing exceptional presentation skills.
- Stay updated on value-based requirements and practices.
- Travel to affiliated regions for training and development purposes.
- Perform additional duties as assigned by management.
Qualifications:
- Strong understanding of HEDIS and Medicare Advantage plans.
- Experience in a primary care environment.
- Completion of a coding course or relevant experience in medical terminology and anatomy.
- Associate degree in health information administration, medical coding, or a related field from an accredited institution, or equivalent experience.
Preferred Qualifications:
- Proficiency in WORD, EXCEL, POWERPOINT, and EPIC.
- At least one year of leadership experience.
- Knowledge of CPT codes and medical record documentation.
- Familiarity with Medicare and Medicaid regulations.
Skills and Abilities:
- Ability to respond effectively to inquiries from various stakeholders.
- Capability to lead and direct the work of others while achieving team goals.
- Strong team-oriented approach with the ability to build effective working relationships.
- Proficient in analyzing and interpreting complex documents.
- Excellent active listening skills and social perception.
- Service-oriented mindset, actively seeking ways to assist others.
- Strong time management skills and the ability to prioritize tasks effectively.
- Proven ability to manage departmental operations while setting short- to medium-term goals.
- Commitment to employee development and creating a supportive learning environment.
- Ability to maintain confidentiality regarding sensitive information.
- Strong decision-making skills, particularly under pressure.
Benefits:
- Comprehensive medical, dental, and vision insurance.
- Generous paid time off.
- Tuition reimbursement programs.
- 401K retirement plan.
- Opportunities for community volunteerism.
Pacific Dental Services is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.
