Manager, Provider Based Clinics

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The primary focus of this job is to manage the team tasked with providing financial and compliance analyses to support organizational leaders across WVU Medicine. This role will be responsible for training staff and maintaining standards to create and compile various reports to support decision making processes as it relates to outpatient services across the health system. The position contributes to meeting the objective goals of the organization, which include system provider-based strategy and ensuring compliance with regulatory requirements to establish WVU Medicine as a premier clinical organization and optimizing reimbursement in every market.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

Bachelor’s degree in Business Administration, Finance, Accounting or related field.

EXPERIENCE:

Minimum five (5) years of experience in healthcare finance or accounting. Minimum one (1) year experience with CMS provider based and/or RHC regulations.

PREFERRED QUALIFICATIONS:

EXPERIENCE:

Prior experience managing a team of professionals.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Uses knowledge of CMS regulations and internal processes to maintain and continually improve an ongoing staff development program and an orientation program for staff on the provider-based team.

2. Demonstrates an ability to create an atmosphere that fosters motivation of staff to work at optimal efficiency and encourages staff to regularly establish and achieve departmental goals.

3. Provides leadership and direction to professional staff and maintains a professional working relationship with all staff, always responds to staff concerns in a professional and timely manner; maintains appropriate interdepartmental communication.

4. Assist with creating and maintaining best practice toolkits, documents, and resources regarding provider-based clinic topics, such as regulatory compliance, financial, reporting, legal, and billing structure.

5. Evaluation of new PBB clinic locations and providing direction and guidance for the set-up of new PBB locations.

6. Interprets and advises key stakeholders on CMS provider-based compliance per 42 CFR 413.65 and alerts leadership to any pertinent changes.

7. Identify and interpret potential changes or new legislation impacting provider-based billing.

8. Serves as first point of contact for department. Interfaces with hospital leadership and staff of various levels, with an ability to translate and communicate business concepts into actionable and meaningful terms.

9. Manage completion of ad hoc financial analysis on clinic reimbursement impact for all hospitals across the health system.

10. Maintains a process for ongoing monitoring of standard Epic designations related to provider-based billing concepts.

11. Conducts and participates in business meetings with clinical leadership.  Includes creating and improving reporting packages, ongoing support, and project tracking.

12. Participates regularly and sometimes leads cross-functional work groups as recommended by the Provider Based Steering Committee.

13. Provides support in problem identification, resolution, and solution design for a variety of business needs.

14. Responds to requests; explores and resolves problems as presented by Department Leadership, IT, clinical departments, and support staff.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to

successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to

perform the essential functions.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters

while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to

perform the essential functions.

SKILLS AND ABILITIES:

1. Effective verbal and written communications skills and strong interpersonal skills are required

2. Extensive knowledge of personal computers, Microsoft Office products

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

540 SYSTEM Finance and Reimbursement