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Homecare Prior Authorization Supervisor

Nationwide Children's Hospital
$41,693 - $51,827 a year
Columbus, Ohio
Full time
5 days ago
Overview:

Outlines responsibilities for leading, mentoring, and motivating a team focused on prior authorization processes. This includes ensuring accurate processing of requests, compliance with regulations and contract requirements, and improving process efficiency. Assign tasks, monitor performance, and adjust resources as needed to maintain productivity and quality.

Job Description Summary:

Oversees the operations of the Referral/Service center of Homecare, managing a team to facilitate patient referrals, service needs, and transitions to home care. Directs centralized intake and client service functions, information management, and initiates steps to resolve issues impacting the Homecare revenue cycle.

Job Description:

Essential Functions:
  • Supervises staff, providing training and support as needed, and manages workflow of team, ensuring appropriate staffing needs are met.
  • Monitors employees’ productivity and quality of work, ensuring accuracy of data entry and information gathering.
  • Manages communication regarding inquiries and complaints and acts as the primary resource for internal and external customers.
  • Develops departmental policies and procedures and reviews organization-wide policies. Identifies opportunities for process improvement, devises solutions, and implements those solutions.
  • Assists with compliance to applicable laws and regulations from federal, state, and local bodies, and from accrediting organizations.

Education Requirement:
Bachelor’s Degree in related field, or equivalent education and experience, required.

Skills:
  • Effective attention to detail, organizational skills, and multitasking abilities, with a proven ability to manage multi-disciplined projects and teams.
  • Excellent communication and customer service skills, with a strong professional demeanor that fosters credibility and rapport.
  • Proficient with computer systems and MS Office.

Experience:
  • Three years of experience in the health care field related to registration, referral process, or intake process, required.
  • One year of medical terminology, public relations, quality improvement, and utilization review experience, required.
  • One year leadership or management experience, required.

Physical Requirements:
OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Standing, Walking
FREQUENTLY: Decision Making, Sitting
CONTINUOUSLY: Audible speech, Computer skills, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
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