Assistant Director, Prior Authorization

Position Summary / Career Interest:

Directs financial clearance activities and teams, including prior authorization capture and validation and notice of admission, work queue management, and incorporation of denials prevention and payer requirements into workflow to minimize revenue leakage. Works with medical, nursing and accounting staff to ensure appropriate financial care is given to all patients. Directs the employee workflow and performance.  Provides direction and leadership to departmental staff, ensuring a high level of customer service is provided.  Interacts closely with Director and supports the overall vision of department and organizational goals.  Works in collaboration with multiple departments within the health system. Supports and adheres to The University of Kansas Health System's Code of Ethics and Business Standards. This role will be hybrid, including both expectation for on-site work on a regular basis as well as telecommuting flexibility.


Responsibilities and Essential Job Functions

• Assists in directing the operational performance and overall management of the hospital prior authorization and notice of admission functional areas.
• Assists in preparing department budget and monitors cost centers within respective downline.
• Ensures accurate and timely processing of assigned functions by establishing and maintaining quality and productivity measures are in place, reviewed and acted on appropriately.
• Work closely and collaboratively with Revenue Cycle Leadership Team, Clinical Leadership Team and Finance Teams to optimize outcomes.
• Implements and monitors compliance with UKHA and governmental and managed care reimbursement policies and regulations as it relates to hospital registration and access areas.
• Maintains a working knowledge of applicable laws, regulations and payer contract agreements as they relate to assigned responsibilities and educates staff appropriately.  Stays abreast of industry trends and drives revenue cycle strategy within assigned area.
• Establishes, maintains and monitors performance of outside vendors supporting assigned responsibilities.
• Provides leadership, motivation and inspiration to downline managers and staff within the department.
• Focuses on departments internal and external stakeholders and support the team’s ability to deliver a high level of customer service and meet customer expectations.
• Provides feedback and works directly with clinical staff and departments to identify trends and to develop and implement action plans for improving revenue cycle workflows.
• Establishes and monitors reports to provide overall status of assigned functions and identify trends.  Shares reports and results as appropriate.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree in Healthcare Administration, Business Administration, Finance or a related field of study from an accredited college or university
• 6 or more years of experience in healthcare revenue cycle operations
• 5 or more years of leadership experience
• Designated Epic training must be completed within 6 months of hire into position

Preferred Education and Experience

• Master's Degree in Healthcare Administration, Business Administration, Finance or a related field of study from an accredited college or university
• 7 or more years of experience in healthcare revenue cycle operations
• 6 or more years of leadership experience

Preferred Language Skills

• Fluent Spanish - Ability to speak, write, and read Spanish.

Knowledge Requirements

• Demonstrated leadership and team management skills
• Solid operational management and process/technology optimization skills
• Excellent personnel management and organizational management skills – including written and oral communication, relationship management, customer service, and organization
• Comprehensive knowledge of patient registration contractual terms and requirements, health insurance practices, and industry standards
• Ability to create and manage respectful and impactful relationships with internal and external stakeholders
• Experience and passion towards mentoring and developing team members
• Proficient in Excel, Word, PowerPoint.
• Ability to travel between Health System locations with minimal to no notice.

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.