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(213) 381-2931

MANAGER, BEHAVORIAL HEALTH REVENUE CYCLE

Schedule: Monday – Thursday, 9am – 6pm; flex Friday, 9am – 5pm
 
Annual Salary: $80,000 – $95,000
 
Location: Main Campus

JOB SUMMARY

Under the supervision of the Chief Financial Officer (CFO), the role’s primary purpose is to ensure that all behavioral health information systems and revenue management systems for the Department of Mental Health (DMH) programs and manage care contracts are performing efficiently. This role provides supervision of the other Revenue Management Staff.

This position works closely with the Clinical Management Team of each site and with the QI team, providing data, analysis and trouble shooting. This role monitors the technological systems and the revenue generating systems to ensure they are accurately performing to their optimal levels by communicating findings to Vice President, Community Based programs, Clinical Program Directors, Vice President, Organizational Quality & Impact, Finance Manager, and working with the appropriate staff and their supervisors. Additionally, the Manager of Behavioral Health Revenue Management assists with the resolution of revenue generating issues and contract utilization related to both in-house systems, managed care, and Los Angeles County DMH system, with an emphasis on data interactions and data analysis as it relates to utilization management. This role is required to engage in project management, problem analysis, and provision of direct user support for problems /questions resolutions and/or other Exym/EHR related matters. This role is responsible for overall contract management utilization.

ESSENTIAL JOB DUTIES:

  • Primary responsibility for overseeing the work of the department and supervision of the Revenue Management personnel and ensure the quantity and quality of Revenue Management personnel work product.
  • Develop timely mental health projection, forecast, and budget in collaboration with program leadership and Finance Manager
  • Responsible for the distribution of the monthly Financial Workgroup Dashboard, Productivity, and other program reports.
  • Demonstrate advanced understanding and support the management of database systems in within the department.
  • Lead in project management for Improvement of St. Anne’s Family Services EHR, trouble ticket, and reporting systems.
  • Work directly with Quality Assurance team by placing proper safeguards in our EHR to prevent inappropriate billing activities.
  • Lead in the maintaining, monitoring, analyzing all in-house and DMH County & State Reports; notifying leadership of any irregularities. This role is a Primary conduit to Exym and must understand all functions of the system and is a primary problem solver.
  • Oversee the provision of detailed reports from claims with problems to the Supervisors identifying the discrete problem and the responsible party to fix the problem(s). Disseminates in-house reports to appropriate supervisors/managers and Director of Mental Health to notify of any irregularities in data and also track trends related to these reports.
  • Collaborate with Clinical Management Team on work flow and ensures that office-oriented directives and policies and procedures are implemented in a timely manner. This role has the primary responsibility of creating all necessary procedure guidelines to instruct the Revenue & Office Support Specialist on all revenue-oriented tasks. Participates in training Revenue & Office Support staff ensuring that the evidence the skill to conduct each aspect of their role and evidences the same to the Clinical Management Team.
  • Maintain up-to-date information on any DMH, Managed Care (if applicable) and EDI issues or changes and disseminate the information to appropriate staff.
  • Assists in monitoring data for identification of QA trends.
  • Coordinate with DMH to ensure 100% compliance to State of California Standards.
  • Utilize and respond to problems noted in the tracking system. Log calls, attempt to resolve problems and route that information to the QIC.
  • Primary Revenue Management representative to Quality Improvement Committee (QIC) and other county revenue committee meetings to address any system or programmatic issues.
  • Maintain positive external contacts, attending all pertinent DMH meetings and trainings related to program, including reporting to funding sources, community resources, collaborative partners, all issues related to Information Systems, etc.
  • Work with Information Technology department to comply DMH or Behavioral Contract/s security standards.
  • Create and expand procedures of Revenue Management Department including cross training of Revenue Management personnel.
  • Responsible for the creation of Negotiation Package for renewal of mental health contract(s).
  • Lead the Mental Health Utilization Manager meetings and address utilization of funds, staff productivity, and claim status.
  • Responsible for the filing of Cost Reports. This also includes researching discrepancies and reconciling Exym vs DMH billing of the prior years’ cost reports.
  • Serve as the primary contract liaison for contract settlements and County requested reports.
  • Verify payments received from DMH and other behavioral health funders and to guarantee that the agency billings are being submitted and paid accordingly.
  • Responsible for contract utilization and reporting.
  • Monitoring DMH mental health contract and ensuring that St. Anne’s Family Services operates within the contract provisions.
  • Lead the preparation for the changes to billing practices that result from county Integrated Behavioral Health Information System (IBHIS) Changes.
  • Serve as the organizational subject matter expert in billing/EHRS, DMH, Managed Care.
  • Support in contract negotiations and business development areas in the behavioral health area(s).
  • Support staff with training and communication of pertinent information affecting the team and other stakeholders.
  • Provide other financial and accounting support as needed.

QUALIFICATIONS:

  • Five years’ experience in IS related to health services required.
  • Minimum four years comprehensive experience related to information technology.
  • Minimum one-year supervisory experience preferred.
  • Minimum Bachelor’s Degree in Business Administration or Information Systems with two years post graduate experience.
  • Exceptional computer literacy including Windows, Word, Access, and Excel required.
  • Advanced understanding of electronic data interface (EDI) and agency-based electronic health record (EHR) system required.
  • Experience with L.A. County Department of Mental Health (DMH) information systems required.
  • Understanding of DMH contracts and provisions.
  • Knowledge of Manage Care Systems in California.
  • Ability to analyze data to assist in identification of QA trends and problem solve through data analysis and technical audits.
  • Strong team and organizational and time management skills.
  • Demonstrated strong communication and interpersonal skills required.
  • Ability to multi-task and perform general administrative duties.
  • Ability to work in a multi-cultural environment required.
  • Excellent interpersonal skills across all levels including co-workers.
  • Ability to receive and implement constructive feedback.
  • St. Anne’s values the dignity and worth of every person we serve. Employees are expected to support children’s emotional and social development by encouraging understanding of others and promoting positive self-concepts. All employees must have the ability to treat those served by our agency in a caring and respectful manner, mindful of individual differences and cultural, ethnic, and socioeconomic diversity.
  • As providers of social services, St. Anne’s employees work with clients dealing with complex emotional and mental health issues, many of whom are facing significant personal crises on a daily basis. Employees must remain aware of any personal emotions, transference, and/or countertransference that may hinder the ability to remain professional. As such, employees are expected to maintain composure during all interactions and crisis situations, implement a self-care plan, and utilize crisis communication to deescalate client crisis and prevent any serious bodily injury or harm.

PHYSICAL DEMANDS

  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job: While performing the duties of this job, the employee is frequently required to walk, use hands to finger, handle, or feel objects, tools, or controls, and talk or hear. The employee is often required to stand and sit; reach with hands and arms; and stoop, kneel, crouch, or crawl.
  • The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
  • Employee may occasionally be required to drive a motor vehicle.
  • Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions

HOW TO APPLY

Internal Candidates (who have been in their current position for at least six months) may submit a Transfer Request Form to Human Resources.

Standard Mail

St. Anne’s Family Services – Human Resources
155 N. Occidental Blvd.
Los Angeles, CA 90026
Fax: (213) 385-1533

Via email: resume@stannes.org

You may send your resume as a part of the body of your e-mail or attach it as a Microsoft Word document or PDF file.

Once a resume or application is submitted to St. Anne’s it is screened and processed. PLEASE DO NOT CALL to inquire about the status of your resume. If you are deemed a good fit for any of our current openings, we will contact you for an interview.

Please note, St. Anne’s conducts a physical, including tuberculosis and drug screen; fingerprinting and background check which includes Child Abuse Index, FBI and Department of Justice, as well as reference checks.

Thank you for your interest in St. Anne’s!