1 day old

Director, Healthcare Services Audit & Recovery Strategic Programs

Performant Financial
Sunrise, FL
  • Job Code
    2018-50-6-021
Performant Financial Corporation

Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

Director, Healthcare Services Audit & Recovery Strategic Programs
Job Code:2018-50-6-021
Location:Sunrise, FL
Status:Regular Full Time
  
Responsibilities:
The Director of Healthcare Services Audit & Recovery Strategic Programs applies subject matter expertise in State and Federal healthcare programs and insurances, Coordination of Benefits (COB) and subrogation, as well as healthcare debtor communities to provide leadership, contribute to strategies, and drive initiatives to support audit and recovery business.

Essential Duties
•Contribute to healthcare business though leadership and program strategies as per each unique contract, program or opportunity and coordinate efforts that support Performant’s ability to meet and exceed contractual service level agreements and programs objectives
•Development and continuous improvement of Performant’s payer community outreach programs for contracts and programs
•Develop outcome-oriented data-driven strategies to optimize the effectiveness of the programs through outreach framework and approaches
•Develops strong relationships with client stakeholders, plans and payer community, credit bureaus and clearing houses, as well as associations and advisory groups
•Evaluate audit and recovery approaches and guidelines as well as audit concept approaches, and make recommendations to improve finding and recovery rates
• Collaborates internally to proactively support strategies and approaches to maximize efficiencies and effectiveness of operations and shared services 
• Serves as partner and trusted advisor for management to optimize the division’s business initiatives and objectives
• Maintains current understanding and insight of the legislative and regulatory environment at both national and state levels 
•Look beyond data to identify and clearly communicate issues and opportunities as well as develop actionable recommendations that ensure achievement of organization’s stated objectives.
•Identifying potential opportunities and effectively communicating service offerings through both internal and external stakeholders
•Providing feedback and performance management to staff
•Travel as required to meet business needs
•Other duties as assigned
 
Required Skills and Knowledge:
•Strong verbal and written communication skills; ability to communicate, develop relationships and influence effectively at all levels both internally and key stakeholders
•Strong analytical and problem-solving skills; ability to analyze diverse information and use sound logic to develop solutions and approaches
•Demonstrated ability to collaborate and drive initiatives in a matrix organization structure
• Strong project and program management skills
•Ability to deal well with ambiguity. Can effectively shift focus and priorities, as well as handle risk and adversity comfortably.
•Mind-set of continuous improvement and adapts quickly to change
•Demonstrates initiative, creativity and innovation to delivering results 
•Ability to influence at all levels in a positive and professional manner that aligns with Performant values and interests
 •Able to solve complex problems, and resolve disagreements with informed, rational debate.
•Demonstrated ability to maintain positive attitude and apply good judgment in fast paced, dynamic environment
•Ability to work proficiently with Microsoft office applications as well as company and client systems

 
Physical Requirements
•Generally, performs work in busy standard office environment (or remote office) with moderate noise level, using computer and phone system (or cell phone)
•Requires ability to read and comprehend information in electronic (computer) or paper form (written/printed), or verbal.
•Requires ability to communicate and exchange information verbally and in writing
•Requires ability to use computer, phone, peripherals and office equipment
•Requires ability to consistently view a computer screen, type, and use a keyboard and mouse
•Requires ability to occasionally lift/carry/push/pull up to 10lbs.
•Requires ability to work business hours and extended hours for business needs 
•Requires ability to travel at least 15% of time based upon business needs
 
Education and Experience:
•Bachelor’s degree or equivalent combination of education and experience
•10+ years of relevant experience with proven track record of success in healthcare payer space including government and commercial programs, with direct responsibility for or strong influential impact for operations, quality assurance, compliance and shared services.
• 6+ years in role with responsibility for staff management and development
•Extensive experience working with Healthcare payers and related regulatory bodies, and current industry events and trends
•Extensive knowledge and experience with audit concepts, operational strategies, and quality assurance practices in the healthcare payer environment

Performant is a government contractor. Certain client assignments for this position may require submission to and successful outcome of additional background and/or clearances throughout employment with the Company. 

-Must submit to and pass background check. Must not have any Federal or State liens resulting from County, State or Federal tax issues. 
-Must not have any current defaulted student loans.
-Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors.
-Must submit to and pass drug screen.

*Job Profile is subject to change at any time and does not preclude the company or management’s right or ability to assign or reassign job duties or assignments at any time. 

Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
 
  

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Posted: 2018-12-17 Expires: 2019-01-16

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Director, Healthcare Services Audit & Recovery Strategic Programs

Performant Financial
Sunrise, FL

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