Patient Financial Services Manager

Prime Healthcare • Garden City, MI

1d

About The Position

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The key objective and purpose of this role is to transfer managerial skills to oversee and manage the large and essential Patient Financial Service division of our large network of hospitals and medical groups. The Patient Financial Service Manager provides critical managerial leadership to ensure consistency and adherence to standardized procedures across multiple facilities’ business offices. The role encompasses a wide spectrum of responsibilities, which include overseeing the complex appeal process with California Department of Managed Health Care (DMHC-CA), Legal Claim Set Review process, No Surprise Act (NSA) process, Employee Retirement Income Security Act (ERISA) process, and other Federal, State, external appeal processes, and acting as an essential facilitator for the integration of new critical processes. This role also involves hiring team members and managing the team to execute the strategies and processes the Manager will design and direct their implementation.

Requirements

• Bachelor’s Degree
• Strong understanding of U.S. healthcare regulations, including DMHC, NSA, ERISA, and other federal and state appeal processes.
• Proven ability to lead and manage cross-functional teams in different geographical locations.
• Excellent strategic planning and project management skills.
• Proficient in developing and implementing process improvements.
• Strong leadership and decision-making capabilities.

Nice To Haves

• Experience working with international teams.
• Certification in project management or healthcare management.
• Proficiency in healthcare, financial software and tools.
• Strong communication and interpersonal skills.
• Ability to navigate and comply with complex regulatory environments.

Responsibilities

• Oversee and manage the Patient Financial Service division.
• Provide managerial leadership to ensure consistency and adherence to standardized procedures across multiple facilities’ business offices.
• Oversee the complex appeal process with California Department of Managed Health Care (DMHC-CA), Legal Claim Set Review process, No Surprise Act (NSA) process, Employee Retirement Income Security Act (ERISA) process, and other Federal, State, external appeal processes
• Act as an essential facilitator for the integration of new critical processes.
• Hire team members and manage the team to execute the strategies and processes the Manager will design and direct their implementation.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees