Alliance HealthCare Services

  • Manager, Government Enrollment

    Job Locations US-CA-Irvine | US-MA-Boston | US-NJ-Camden | US-ID-Meridian | US-GA-Atlanta | US-TN-Nashville
    ID
    2018-14244
    Category
    Management
    Position Type
    full-time
  • About Us

    At Alliance HealthCare Services, our focus is on transforming the customer and patient experience. Vital to our success are the Corporate Team Members who collaborate with clinical, operational, and sales teams in the field. We focus on delivering improved processes, innovative new services, and business solutions that differentiate and advance our comprehensive clinical services—always with our patients’ and customers’ needs in mind.

     

    Job Responsibilities

    Location:  Irvine, CA - RELOCATION ASSISTANCE AVAILABLE

    Fantastic opportunity to grow with Alliance HealthCare Services in this unique role

     

     

    The Manager of Government Enrollment will supervise all aspects of Alliance Healthcare Services government healthcare provider enrollment programs. The primary responsibility of the Manager is to ensure that Alliance is in 100% compliance with all Medicare and Medicaid regulations and timely filing requirements.  The Manager will be the guardian of the active Medicare and Medicaid certifications with the responsibility for ensuring that there is never a time when Alliance  is in jeopardy of having any certification revoked or terminated. This is a corporate level role that requires the Manager to work directly with all other Alliance departments and divisions to provide the requisite information needed to complete initial and revalidation applications accurately and within the timeframe required by Medicare and Medicaid. In the event Medicare or Medicaid sends back a development request, the Manager will ensure accurate and timely responses that include engaging the legal department to develop an appeal when Alliance disputes the position Medicare or Medicaid is taking related to any particular regulation. The Manager supervises the Team Members who complete the Alliance provider enrollment applications, revalidations and updates for governmental healthcare programs, including Medicare and Medicaid. The role is responsible for ensuring that all Alliance Independent Diagnostic Testing Facilities (“IDTFs”) pass onsite inspections by Medicare and State Medicaid inspectors in order to remain compliant with the IDTF performance standards and other Medicare/Medicaid requirements. The Manager develops precise and rigorous training materials and training programs for newly hired Team Members. When there are significant changes to either the Medicare or Medicaid regulations or a change to Alliance's ownership structure, the manager prepares training materials and specific training programs for all internal staff including the Manager’s direct reports, Business Development, Sales, and Operations on the issues and their impact to the IDTF site operations. The Manager is the subject matter expert on Medicare and Medicaid regulations and acts in the capacity of being a resource to others in the company.

     

    The Manager of Government Enrollment is responsible for the implementation of the systems and processes necessary to support efficient and effective activities within the Managed Care department. This includes developing and using tracking reports to monitor department and individual Team Member results to ensure key performance indicators are met each month.

     

    Specific duties include, but are not limited to: 

    • Leads all aspects of Government Enrollment including process improvement initiatives and implementation of processes to improve efficiency and effectiveness of the team. Meets or exceeds all personal and department Key Performance Indicators (KPI’s).
    • Oversees the 100% accurate and 100% timely compliance of government provider enrollment applications and updates, as well as ensures that IDTF inspections are passed and IDTF performance standards and other Medicare/Medicaid requirements are compliant.
    • Provides direction and training to staff to ensure the department meets production and quality assurance goals defined for this position. Provides assistance to other Alliance departments and works closely with the Legal department in developing communication and training with respect to Medicare and Medicaid regulations.
    • Responsible for oversight of all Medicare and Medicaid regulations including staying abreast of new guidelines and their ramifications to Alliance as well as developing new policies and procedures to support new or changing regulations.

    Position Requirements

    • Bachelor's Degree or equivalent experience required.
    • Seven (7) years of work experience in Healthcare, Business Management or Public Health Administration.
    • Minimum of five (5) years of progressive managerial experience.
    • Minimum five (5) years of experience enrolling healthcare providers in Medicare and Medicaid with 100% timely filing compliance and 100% accuracy.
    • Experience with Independent Diagnostic Testing Facilities (IDTF) Medicare/Medicaid enrollment including direct knowledge of the approximate 1,400 pages of Medicare regulations that govern IDTF’s.
    • Direct interaction with the Medicare MAC’s and the State Medicaid Agencies.
    • Updating and managing the accuracy of the Alliance data stored in the Medicare PECOS system.
    • Developing and implementing improved workflow processes.
    • Highly organized with excellent written and verbal communication skills.
    • Excellent analytical and critical thinking skills, to include the ability to read, extract and interpret information.
    • Superior logic, problem solving and project implementation skills.
    • Extensive experience creating, using and manipulating Excel Spreadsheets.
    • Ability to perform comfortably in a fast-paced deadline-oriented work environment.
    • Microsoft Office skills required.
    • Must be independent and self-motivated requiring minimal supervision.
    • Previous experience working with complex ownership structures and accurately reporting those ownership structures to Medicare and Medicaid a plus.
    • Knowledge of the ViStar eVips system a plus.
    • Previous employment by Medicare or a State Medicaid agency a plus.

    Key words:  provider enrollment, IDTF, government enrollment, ancillary, managed care, medicare, medicaid

    *LI-SP1

    A division of Alliance HealthCare Services, we are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, age, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.

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