Experience:
5+ years of experience
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Employment Type:
Full time
Posted:
4/12/2018
Job Category:
Health Care Provider
Industry:
Health Care & Medicine
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Financial Data Analyst
Children's National Health System | Silver Spring, Maryland
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Job Description

Qualifications

 Minimum Education
Bachelor's Degree

Specific Requirements and Preferences
Responsible for executive dashboard reporting, denial management leadership, vendor management and overall business intelligence support in direct support of the Vice President of Revenue Cycle.

Minimum Work Experience
5 Year(s)

Specific Requirements and Preferences
At least 5 - 7 years of healthcare experience in decision support, finance or related financial analysis background, including experience with hospital/physician information and patient accounting information systems (preferably Trendstar, McKesson STAR, Cerner). At least 5 years of broad Revenue Cycle operations experience or deep denial management experience preferred.


Required Skills/Knowledge
Proven analytical skills including, ability to make recommendations based on financial analysis. Have superior PC skills including proficiency in Word, spreadsheet analysis and database management. Ability to work in a team environment with other analysts, managers, and physicians. Proficiency in presentation of analytical results. Ability to support the VP of Revenue Cycle, Finance and the CFO with key reporting and trending relating to overall business intelligence including denial management, vendor management and Key Performance Indicator (KPI) dashboards. Demonstrated advanced proficiency in desktop computer programs such as Microsoft Excel, Access and ability to conduct data mining and broad denials research. Demonstrated knowledge of managed care payer requirements in an acute setting. Demonstrated ability to facilitate team or group activities and demonstrated leadership qualities including professional verbal and written communication skills. Demonstrated ability to be flexible and to prioritize workload, decision-making skills, and professional development through participation in continuing education and professional organizations. Ability to train clinical staff on new technologies and processes, and to analyze workflow for process improvement. Strong organizational and coordination skills required. Experienced in department budget, contract modeling, healthcare statistics and interpersonal communication preferred. 



Functional Accountabilities

Department Strategic Planning
  1. Contribute to the strategic plan for Revenue Cycle services, include short-term and long-term objectives.
  2. Appropriately utilize industry information (e.g. from HFMA, AAHAM, etc.) and CNMC peer resources (e.g. State Hospital Association, CHA) to understand national and regional denial trends, peer hospital innovations and successes relating to denial management.
  3. Provide strategic support of AR Strategy as it relates to items such as small balance and bad debt vendor thresholds as needed.
  4. Define and measure vendor contribution to organizational and departmental targets.
Program and Service Administration and Implementation
  1. Implement strategic plan through management of day-to-day operations of data and vendors related to Revenue Cycle; responsible for overall Revenue Cycle Dashboard reporting on both a weekly and monthly basis, whcih include data mining and report interpretation to ensure key themes are identified, addressed and escalated appropriately to VP of Revenue Cycle.
  2. Collaborate with upper management to evaluate current as well as new program initiatives for effectiveness, feasibility, performance measurement and cost; ensure compliance with organizational and departmental policies and procedures, and regulatory standards.
  3. Analyze data on all Revenue Cycle KPIs related to Patient Access, Patient Accounting, and Revenue Integrity.
  4. Oversee the biweekly (or monthly) denial management committee and appropriately coordinate and involve key accountable stakeholders in a collaborative manner from PAS, CRM, HIM, Patient Accounts, specified ambulatory areas, and Finance and Managed Care Contracting; drive root cause identification and action plan tracking for the purpose to reduce/eliminate drivers of denials; provide ongoing denial management updates at the monthly Revenue Cycle Steering Committee.
  5. Develop and maintain an “appeals” toolkit which include template letters organized by type of denial to facilitate hand-off and coordination of clinical denials with CRM and/or vendor resources and for the coordination of administrative denials with Follow-up staff.
  6. Appropriately involve the VP of Revenue Cycle or CFO to ensure accountability occurs across key stakeholder areas; appropriately raise issues and challenges so that these individuals can help champion denial management initiative across CNMC; Special projects, facilitation and decision support at the discretion of the VP of Revenue Cycle.
Information Resources Management
  1. Acts as the “super user” of the DMS / Streamline denials management system and for denials related reporting in the McKesson STAR / Cerner system; provide key input and participation on any system upgrade or enhancement affecting these systems.
  2. Maintain a database of denial and appeal results which is appropriately supported from the STAR and Streamline systems and provide periodic succinct updates to the RC Director and Finance; provide YTD summary trends on denial volumes, appeals filed, denials overturned, trends by payer, etc.
  3. Develop a familiarity with underpayment review system to understand the payment variance process and how this software will interface with STAR/Cerner.
  4. Perform analysis and “data mining” of denials information using analytical tools (Excel, Access) and available reporting in Streamline; oversee data analysis, trending and management reporting related to Revenue Cycle.
  5. Routinely identify enhancements to reports and/or tools to support leading practice processes and facilitate continuing Revenue Cycle improvement; provide content expertise in the development, implementation, revision and management of data systems that support the Revenue Cycle.
  6. Actively support any initiatives related to Revenue Integrity and ensure organizational preparedness and compliance (such as Cerner).
Budget and Financial Management
  1. Work with Vice President throughout the year and participate in the budgeting process to identify volume impacts, equipment needs, resource needs.
  2. Implement actions to administer programs within budgetary guidelines.
  3. Mitigate financial risks for the organization and departments with the organization associated with the processes and programs reporting to the Vice President.

Organizational Accountabilities (Staff)

Organizational Commitment/Identification
  1. Partner in the mission and upholds the core principles of the organization
  2. Committed to diversity and recognizes value of cultural ethnic differences
  3. Demonstrate personal and professional integrity
  4. Maintain confidentiality at all times
Customer Service
  1. Anticipate and responds to customer needs; follows up until needs are met
Teamwork/Communication
  1. Demonstrate collaborative and respectful behavior
  2. Partner with all team members to achieve goals
  3. Receptive to others’ ideas and opinions
Performance Improvement/Problem-solving
  1. Contribute to a positive work environment
  2. Demonstrate flexibility and willingness to change
  3. Identify opportunities to improve clinical and administrative processes
  4. Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility
  1. Use resources efficiently
  2. Search for less costly ways of doing things
Safety
  1. Speak up when team members appear to exhibit unsafe behavior or performance
  2. Continuously validate and verify information needed for decision making or documentation
  3. Stop in the face of uncertainty and takes time to resolve the situation
  4. Demonstrate accurate, clear and timely verbal and written communication
  5. Actively promote safety for patients, families, visitors and co-workers
  6. Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
 

About Children's National Health System

Childrens National Medical Center is the only exclusive provider of pediatric care in the metropolitan Washington area and is the only freestanding childrens hospital between Philadelphia, Pittsburgh, Norfolk, and Atlanta. Serving the nations children for more than 130 years, Childrens National is a proven leader in the development and application of innovative new treatments for childhood illness and injury.

Childrens National is proudly ranked consistently among the best pediatric hospitals in America by US News & World Report.

Our Culture

Children's mission is to be preeminent in providing pediatric health care services that enhance the health and well-being of children regionally, nationally and internationally. Through leadership and innovation, Children's creates solutions to pediatric healthcare problems. Children's excels in Care, Advocacy, Research, and Education to meet the unique needs of children, adolescents and their families. Children's leadership realizes that our employees are the heart of our medical center and the soul of our mission. One of our greatest assets is the diversity of our workforce, which adds to the richness of our culture. Teamwork, dedication, and professionalism are essential values and characteristics that make our employees unique.

Childrens internationally recognized team of pediatric healthcare professionals care for more than 360,000 patients each year who come from throughout the region, nation and world. Our employees share a sense of pride and commitment to the patients and families we serve. We aspire to provide patients and their families with the highest quality of care and service in a family-centered environment. In essence, we are a team of "Great People Providing Great Care."

Nursing Students

As a nursing student, you might already be craving hands-on experience at a highly respected hospital. You may be thinking about where or with which population you want to work after graduation.

At Childrens, a world-class teaching hospital and internationally-recognized leader in pediatric health, we invite nursing students at all stages of learning to explore the real world of working in a hospital setting and experience first-hand the challenges and rewards of this career.

Internship Program

The internship program provides the novice nurse with the knowledge base and skill set needed to transition to competence in clinical nursing practice. While providing the needed skills to meet the organization goals and mission, the program provides nurses with the leadership skills to work collaboratively within a multidisciplinary team. The program bridges the gap between undergraduate education and real-life professional nursing practice, delivering state-of-the art pediatric care.

The program is offered to new graduate nurses from an accredited nursing program with a passion for children. All new graduates, with less than one-year acute care experience, are eligible to participate in the program after obtaining licensure.