Supervisor Insurance Operations - Museum District - Hybrid

At Houston Methodist, the Supervisor of Insurance Operations position is responsible for providing day to day oversight of the operations related to any of the following areas assigned to them: physician, APP, and other qualified healthcare professional payer credentialing, insurance verification, authorization, and revenue cycle training team ensuring that training content and deliverables support the organizational objectives.

The supervisor position responsibilities include overseeing the daily work activities of the work unit/department staff, ensuring quality, productivity, functional excellence and efficiency. This position trains and supervises staff while maintaining adequate staffing levels and budget compliance. The supervisor position contributes to staffing decisions such as hiring, coaching and counseling employees on work related performance. This position assists in the development and implementation of policies and procedures to ensure a safe and effective work environment. Other duties for the supervisor position include participating in performance improvement activities, as well as providing support for department management to achieve operational goals. This position may also perform staff duties and responsibilities as needed.

FLSA STATUS
Exempt

QUALIFICATIONS

EDUCATION

• High School diploma or equivalent education (examples include GED, verification of accredited homeschool equivalency, enrollment, or completion of post-secondary education, etc.)
• Associate degree preferred

EXPERIENCE

• Four years of physician office insurance verification, authorization, or payer credentialing experience
• 1 year of lead or coordinator experience preferred

SKILLS AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate through a variety of channels with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles; engages the recipient(s) and helps them understand and retain the message
• Demonstrates the ability to interact with others in a way that gives them confidence in one’s intentions and those of the organization
• Demonstrates leadership qualities and critical thinking through self-direction initiative, effective interpersonal skills, and oral/written communication skills
• Ability to identify and understand issues, problems and opportunities; and recommend solutions
• Ability to work effectively in a fast paced environment
• Demonstrates flexibility and adaptability in the workplace
• Functional knowledge of physician payer credentialing, insurance verification, authorization, or revenue cycle processes.

ESSENTIAL FUNCTIONS

PEOPLE ESSENTIAL FUNCTIONS

• Participates in management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees in the department. Provides development and mentoring of staff. Ensures that all department staff are properly trained and comply with all policies and procedures. Assists with meeting or exceeding threshold goal for department turnover.
• Consults with department leadership on coaching/corrective counseling and staff performance to achieve desired outcomes. Conducts new hire feedback sessions and provides recognition/commendations, as appropriate.
• Creates and maintains an environment of collaboration by role modeling teamwork within the department. Effectively interacts within and between departments ensuring seamless flow of information/communication. Role models clear and professional communication to facilitate problem resolution to achieve mutual understanding. Teaches others to critically think by verbally expressing rationale for decisions and follows up consistently.
• Meets or exceeds threshold goal for department and/or system metrics on employee engagement indicators.
• Ensures adequate day to day staffing of assigned areas to support the volumes of visits requiring insurance verification and authorization and makes sure all the required elements are completed and in place prior to the patient appointment. Adjusts assigned workloads, as necessary.
• Monitors the daily/weekly/monthly productivity and quality of assigned staff and provides ongoing feedback/education/improvement plans to staff as appropriate. Ensures revenue cycle training schedules are staffed accordingly.

SERVICE ESSENTIAL FUNCTIONS

• Oversees daily department operations, schedule and activities. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high customer/patient satisfaction.
• Organizes the workflow, proactively problem solves, anticipates needs, and manages multiple ongoing priorities. Provides reports to management of needs, issues to be addressed, and all important information necessary to ensure department success. Serves and actively participates on various committees as directed.
• Communicates with Insurance Operations and other Revenue Cycle leaders to solve existing and/or potential problems related to payer credentialing, insurance verification, authorization, revenue cycle training related processes.
• Communicates schedule and training activities to stakeholders.
• Oversees creation of standard training content for all aspects of daily clinical and back end operations that directly impact revenue cycle workflows.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Ensures a safe and effective working environment; assists in monitoring and/or revising the department safety plan and/or any specific accreditation/regulatory agency required safety guidelines.
• Uses and optimizes information systems to enhance operations; participates in performance improvement and data management/analysis functions as directed.
• Employs a proactive approach in the optimization of positive outcomes by monitoring and improving the department workflow, supporting peer-to-peer accountability, and identifying solutions via collaboration. Role models situational awareness, using teachable moments to improve safety. Participates in investigations as a result of the root cause analysis process as assigned by manager.
• Monitors self and ensures employee compliance with policies, procedures, and System HR Standards of Practice and performs associated actions upon non-compliance (i.e., focal point review requirements, disaster plan, inservices, influenza immunization, wage and hour, standard hours, timely termination submission, timely timecard approval, etc.).
• Reconciles and audits insurance verification and authorization work to ensure accurate and timely collection and recording of the information.
• Takes appropriate action/initiative to ensure that identified departmental goals and targets are met.

FINANCE ESSENTIAL FUNCTIONS

• Assists in the management of essential and non-essential department expenditures to achieve financial target through optimization of productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications.
• Manages staffing needs including scheduling, time off requests and time keeping.
• Contributes to the collection of data to support key metrics for the Insurance Operations functions and generates relevant system reports.
• Assist in the implementation of training and action plans that optimize revenue cycle operations.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Implements change, demonstrating the ability to motivate employees and follow through to ensure change in behavior has actually occurred. Supports Houston Methodist and department goals and vision. Identifies industry trends and implements innovative solutions for practice or workflow changes to improve department operations.
• Develops skills of team members and continually assists with improving competencies, performance and outcomes. Fosters a positive and constructive teaching environment by engaging staff/team members in learning opportunities that are valuable and in alignment with business objectives. Conducts conversations with staff on their development and My Development Plan (MDP).
• Seeks opportunities to identify self developmental needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates MDP on an on-going basis.
• Collaborates with team members and other revenue cycle leaders to bring forth and implement innovative technologies and/or processes for continual revenue cycle performance.

SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): Yes

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.

• On Call* Yes

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area Yes

QUALIFICATIONS

EDUCATION

• High School diploma or equivalent education (examples include GED, verification of accredited homeschool equivalency, enrollment, or completion of post-secondary education, etc.)
• Associate degree preferred

EXPERIENCE

• Four years of physician office insurance verification, authorization, or payer credentialing experience
• 1 year of lead or coordinator experience preferred