Intake Manager

2 weeks ago

Lee's Summit, United States HERITAGE BIOLOGICS LLC Full time
Job DescriptionJob Description

Intake Manager Job Description

The Intake Manager will report directly to the Senior Director of Operations. He/she will be responsible for managing all intake and admission services. He/she will oversee all activities related to benefits verification & investigation, prior authorization management, referral documentation, admission guidelines, and transfer/triage coordination. The Intake Manager will be responsible for promoting continual process improvement within the department and execute department initiatives in support of identified company goals and objectives.

In this role, he/she will have access to Protected Health Information (PHI) and Electronic Protected Health Information.

The Intake Manager will ensure communication with all stakeholders is completed.

Job Responsibilities and Essential Functions

  • Supervise all Intake department staff members, facilitate orientation for new intake staff, and coordinate ongoing training and competencies.
  • Coordinate with Heritage Biologics operations team regarding referrals including providing updates as necessary to external stakeholders.
  • Ability to complete and interpret benefit investigation including experience with insurance coverage for infusion therapies.
  • Ability to accurately identify guidelines, coverage rules, and obtain prior authorizations as required by insurance plans.
  • Manage and assist with prior authorization submission and reviews including ability to review and interpret medical policies and documentation.
  • Supervise referral intake and admission calls with patients or caregivers.
  • Actively seek a resolution to identified issues in the department and advocate for process changes, as necessary
  • Identify and implement intake and admissions performance objectives.
  • Support and assist in implementation of operational needs related to new therapies, including limited distribution products. This includes researching and building out necessary templates related to benefits investigation, prior authorization, and admission calls.
  • Collaborate with Operations and IT teams to develop and strategize new therapy programs and implement best practice standards for admissions.
  • Provide passionate leadership and direction to Intake staff members by maximizing talent within department.
  • Adjust work distribution to ensure core values and company goals are achievable.
  • Managing intake workflow to ensure efficiency and professional communication is provided to internal and external parties.
  • Ensure admissions calls include all necessary components as required by accrediting bodies and state and federal regulatory bodies.
  • Support the Executive Leadership team on various projects and goals, as needed.
  • Manage Intake team to enhance organization reputation by accepting ownership of accomplishing new and different requests, continue to promote opportunities.
  • Actively educates team on therapies provided by company and can educate on services provided.
  • Provides feedback and guidance to team members and completes yearly performance evaluations.

Required Qualifications

  • High School Diploma or equivalent.
  • 5 years’ experience as an Intake or Admissions coordinator or specialist
  • Computer Proficiency
  • Excellent and effective communication skills, both verbally and in writing
  • Strong understanding of insurance coverage and requirements necessary for accurate benefits verification and prior authorizations.
  • Excellent customer service skills
  • Proficiency with Microsoft Office
  • Soft skills required:
    • Team Leadership: Ability to inspire and guide a team, fostering a collaborative and productive work environment. Always willing to work as a team towards a common goal.
    • Conflict Resolution: Skill in addressing and resolving disputes or issues within the team or with external stakeholders.
    • Mentoring: Capacity to coach and develop staff, providing feedback and support for their professional growth.
    • Interpersonal Communication: Proficiency in interacting with various stakeholders, including patients, payers, and other departments.
    • Presentation Skills: Ability to convey complex information clearly and effectively to executive management and other key stakeholders.
    • Active Listening: Skill in listening to understand concerns, feedback, and needs, and responding appropriately.
    • Decision-Making: Ability to make informed, data-driven decisions that align with organizational goals.
    • Innovative Thinking: Capacity to think creatively and identify new approaches to improve intake processes.
    • Negotiation Skills: Ability to effectively negotiate with payers and other stakeholders to resolve disputes and secure favorable terms.
    • Accuracy: Meticulous approach to reviewing billing, coding, and compliance to ensure correctness and prevent errors.
    • Quality Focus: Commitment to maintaining high standards in all aspects of the intake and admissions process.
    • Adaptability & Flexibility: skilled in adapting to industry changes, regulatory updates and organizational shifts while maintaining an ability to remain effective under pressure and managing stress in fast paced environments.
    • Empathy: Ability to understand and address the needs and concerns of patients and payers with compassion.
    • Service Excellence: Commitment to delivering outstanding service and support to internal and external stakeholders.
    • Passion: Passionate about the purpose to ensure all patients are supposed throughout their healthcare journey.
    • Trustworthy: Ability to build relationships with internal and external parties based on consistency, reliability, and transparency.
    • Ownership of Outcomes: Ability to demand accountability of roles and responsibilities for team and self.
  • Language Skills: Ability to read, analyze, and technical journals, system application manuals, basic financial reports, and basic legal documents.
  • Mathematical skills: Ability to solve simple math problems and analyze numbers as they relate to necessary job functions.
  • Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions.
  • Additional skills required:
    1. Multi-tasking, listening, teamwork, people skills, documentation skills, PC proficiency, organization, customer service, creating a safe and effective environment.

Preferred Qualifications

  • Bachelor’s degree
  • Minimum 2 years in healthcare related leadership role
  • Experience with complex prior authorizations and reviewing medical policies and documentation
  • Minimum 2 years experience in specialty pharmacy with infusion therapies
  • Experience with CPR+ or Caretend management system

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