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Full Time
11/6/2024
Owings Mills, MD 21117
(7.6 miles)
MANAGED CARE MANAGER-PAYER RELATIONS AND CONTRACTING Owings Mills, MD SINAI CORPORATE MANAGED CARE Full-time - Day shift - 8:00am-5:00pm Management & Supervisory 84401 $44.71-$71.54 Experience based Posted:October 23, 2024Apply NowSave JobSaved SummaryJOB SUMMARY:Provides experienced Managed Care Payer contracting negotiationskills and subsequent implementation and ongoing operational support for LifeBridge Health entities.Provides project support and acts as an internal liaison and resource for LBH staff and physicians, in addition to acting as an external liaison with payer representatives for resolution of operational and contractual issues.JOB REQUIREMENTS:Seasoned professional knowledge; equivalent to a Master's degree; knowledge in more than one discipline5-7 years of experience in payer negotiation to include financial analysis and contract languageAdvanced Excel skillsAbilityto lead and negotiate all provider types, such as Ambulatory Surgery, Hospice, Home Health, Physicians, Skilled Nursing, Urgent Care and other ancillary services as needed.Strategic planning experienceAbility to build collaborative relationships internally and externallyMarket/Insurance landscape-must understand the insurance players and products-Commercial (HMO/ASO/EPO/PPO), Medicaid and Medicare AdvantageAbility to multi taskKEY WORDSContract negotiationsAnalyticsManaged careAdditional InformationAs one of the largest health care providers in Maryland, with 13,000 team members, We strive toCARE BRAVELYfor over 1 million patients annually. LifeBridge Healthincludes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland. Share:Apply Now
Full Time
11/6/2024
Baltimore, MD 21202
(9.9 miles)
PATIENT NAVIGATION MANAGER Baltimore, MD SINAI-HOSPITAL RIAO ADMINISTRATIVE Full-time - Day shift - 8:00am-5:00pm Professional 86134 Posted:TodayApply NowSave JobSaved SummaryJOB SUMMARYThe Patient Navigation Manager is a working manager who is responsible for the daily supervision of departmental staff consisting of a team of agents representing a specific scheduling team focusing on the daily operation of the various telephone access functions, which can include, scheduling, registration, insurance verification, referrals, triage, etc. The manager will act as a vital member of the Contact Center Team to ensure that all Contact Center policies and procedures are consistent with established LifeBridge Health protocols. Additional responsibilities include staff training and education regarding customer service, patient and department complaint resolution, and efficient departmental operations.ESSENTIAL FUNCTIONSOperations - Implements, organizes, directs, and manages contact center strategies and operations; improving systems and processes; managing staff directly to ensure effective daily operations and positive morale. Supports departmental goals and inbound specific patient contact metrics as established by leadership. Reviews Contact Center reports; analyzes call data; identifies potential call response stress points and recommends solutions. Organizes department personnel schedules to ensure optimal staffing to attain call targets and attain or exceed goals. Prepares payroll and completes work schedules as needed to ensure adequate staffing levels. Supervises and maintains the productivity of agents focusing on maintaining and/or exceeding certain contact call performance targets, metrics, KPIs, etc. Complies and ensures all Contact Center departmental policies and procedures are defined, maintained, distributed, and enforced accordingly. Assumes on-call responsibilities to ensure adequate staff and problem-solving in a timely manner with minimal impact on the department. Performs all other duties as needed or directed to meet the needs of the departmentQuality Assurance - Reviews and audit calls and patient scheduling calls. Performs regular QA agent evaluations and coaching instructions in a timely manner to help agents reach optimal individual performance as prescribed by the department. Serves as the primary resource for patient/caller complaint escalations and ensures matters are resolved promptly and documented accordingly. Completes cyclical reports as needed and as assigned for productivity, quality assurance, volumes and provides them to leadership. Monitors progress and communicate successes and opportunities to management in a timely and appropriate manner. Ensures compliance with all regulatory requirements as identified by OIG, TJC, CMS, HSCRC and the like. Maintains current knowledge of all compliance issues such as HIPAA. Establishes protocols to manage compliance for your scheduling team agents/representatives within the Contact Center.Leadership & Teamwork - Work collaboratively with internal Medical Group & Health System contact center customers to support all KPIs and strategic goals. Exhibits leadership skills that are guided by LifeBridge Health’s mission and is consistent with the Contact Center’s team goals and objectives. Conducts themselves in a professional manner and holds themselves and staff members accountable for efficient performance. Works closely with fellow supervisors and managers to ensure all procedures regarding patient scheduling is completed in a thorough and timely manner. Interview, hire, evaluate, and counsel Contact Center staff members. Works closely and professionally with Medical Group, physician and administrative staff, and hospital and ancillary departments in an effort to maintain a teamwork approach. Conducts regular staff meetings for all assigned areas in collaboration with fellow Supervisors and Managers. Maintains a professional collaborative relationship with all LifeBridge Health clinical departments. Complies with the behavioral expectations of the department and LifeBridge Health. Demonstrates an understanding of the job description, performance expectations, and competency assessment. Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to customer service standards. Recruits, interviews, hires, trains and performs mandated employee evaluations in a timely fashion and as defined by the organization. Actively seeks ways to control costs without compromising performance.REQUIREMENTS -Basic professional knowledge; equivalent to a Bachelor’s degree; working knowledge of theory ad practice within a specialized field. Experience - 1-3 years.Additional Information As one of the largest health care providers in Maryland, with 13,000 team members, We strive to CARE BRAVELY for over 1 million patients annually. LifeBridge Healthincludes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland. Share:Apply Now
Full Time
11/6/2024
Baltimore, MD 21202
(9.9 miles)
CLINICAL OPERATIONS SUPERVISOR Baltimore, MD SINAI-HOSPITAL CLINICAL PRACTICE TR Full-time - Day shift - 8:00am-4:30pm Management & Supervisory 85470 $41.26-$63.95 Experience based Posted:October 23, 2024Apply NowSave JobSaved SummaryPosition Summary: Under the general supervision of the Director of Ambulatory Clinical Practice, in collaboration with senior and operational leadership, functions as part of the LifeBridge Health Medical Group (LBHMG) management team, to assume responsibility for supporting the provision of the highest quality clinical care and services in primary and specialty practices. Establishes and ensures the standardization and safety of clinical practice, the compliance with all State and regulatory standards, governing bodies, and recognition of required programs and servicesTasks:Conducts frequent site visits with practice management at practices to observe the environment of care and clinical staff. Prepares for survey including The Joint Commission, CARF, VFC, etc. as directed. Directs practice leadership in the evaluation of clinical staff performance by shadowing patient care and evaluating skills/competencies/workflows as applicable.Engages with all levels of the organization from front-line staff to Senior Management. Provides planning, coordination, and education of clinical quality initiatives to improve clinical outcomes to achieve LifeBridge Health Medical Group (LBHMG) short- and long-term goals and objectives.Assists in the management of clinical teams to identify and implement waste reduction and safety initiatives to design processes that maintain a safe environment for patients and employees using process improvement techniques (e.g., Lean, PDSA, RCA, etc.) and practices regarding lean principles. Focuses on creating value, eliminating waste, and striving for continuous improvement.Directly leads clinical staff in identifying patient and family clinical needs, while ensuring integration of services into daily operations. Encourages the development of excellent customer service relations to improve CG-CAHPS in primary and specialty care settings. Determines the need for improvement activities and evaluates the impact of those efforts.Requirements:Education:Bachelors of Nursing required, Master of Nursing preferredLicenses and Certification(s):Maryland Registered Nurse LicenseAmerican Heart Association CPR CertificationANCC Ambulatory Care Certification preferredAmerican Heart Association Heartcode only7+ Years of Experience RequiredAdditional Information As one of the largest health care providers in Maryland, with 13,000 team members, We strive to CARE BRAVELY for over 1 million patients annually. LifeBridge Healthincludes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland. Share:Apply Now
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