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Finance & Compliance Manager(Healthcare)

  • Columbus, OH
  • Direct Hire
  • Job ID: OH159-2690928

$69000 to $96000 Per Year

Job Title: Finance & Compliance Manager(Healthcare)
Location: Columbus, OH
 
Are you considering a career change?
Looking for a smaller community(25K population), that offers a low cost of living(18% lower than US average) and plenty of activities in the area but is within an hour of a large city.
If so, an opportunity to work with an integrated health care system based in east central Ohio is looking for someone to join their team.
The system is a not-for-profit and has over 300 physicians and multiple outpatient care centers throughout the area.
The system is the largest provider in a six county region and a primary referral center.
It offers a higher level of service than what is typically found in a community of its size including open-heart surgery, trauma care, a Level II neonatal intermediate care unit, neurosurgery and
comprehensive cancer services.
They are proud of their rich history of serving the community and vow to continue the tradition of healing and caring with compassion, trust, innovation and excellence.
SUMMARY:
Manages the workflow of the billing department staff and ensures that accurate, timely billing processes are performed.
Works with Director of Pharmacy to prepare and monitor budgets for all stores.
Responsible for preparation of financial reports and ensures that accurate policies and processes are in place and followed by all businesses.
Oversees internal audits on billing and other procedures.
Provides leadership and coordination of all external analytical, numerical, or technical audits.
Analyzes efficiencies, ensures proper documentation and credentialing, and assists in maintaining consistencies in all practices.
SOME ESSENTIAL DUTIES:
-Prepares and presents comprehensive monthly reports, financial statements, and statistics, including but not limited to, trend analysis for all the businesses.
Items to be included in these reports: operating margin; days in accounts payable; days in accounts receivable; revenue per prescription, and cost per prescription or any additional reporting requested by the Director of the Pharmacies or the Leadership team.
-Establishes financial operational strategies by evaluating trends; establishing critical measurements; determining production, productivity, quality, and customer services strategies; assist in designing systems; evaluating resources, resolving problems, implementing change.
-Analyzes, prepares, and presents statistical and longitudinal data, utilizing multiple modalities of documentation.
Develops finance organizational strategies by contributing financial information, analysis, and recommendations to strategic thinking and direction; establishing functional objectives in line with organizational objectives.
-Develops financial strategies by forecasting capital, monitoring inventories, identify opportunities for improvement, cost reduction and system enhancements.
-Participates in pharmacy manager quarterly financial review by presenting relevant business metrics, including but not limited to scorecard, year to date financial reports, and quality measures.
-Oversees and reports scorecards for all businesses.
-Oversees credentialing and ensures proper documentation meeting deadlines for submission in all state and national platforms for all the businesses to maintain current provider status.
-Supervises, trains, and develops the billing staff in a manner that promotes independent, effective, and efficient productivity. Oversees their workloads, holds monthly meetings, performs evaluations, and approves work schedules.
-Oversees monthly billing procedures in the areas of contractual adjustments, Medicare and Medicaid payments, reconciliations, and accounts receivable.
-Reviews payables.
-Reviews contracts with regards to pricing issues to ensure appropriate reimbursement.
-Oversees all audits, analysis, and follow-up.
-Oversees 340B reporting for Facility, Respiratory, and manages the Health Center's 340b or any other future 340b partner to the Pharmacies to ensure accurate reporting and use of 340b programs.
-Reviews and processes wholesaler and buying group rebates.
-Serves as a consultant to the billing staffs of the Oxygen & Medical Equipment, Pharmacy Nursing Home Division, and Home Infusion divisions.
-Serves as back up to the billing office staff as needed.
-Updates job knowledge by remaining aware of new regulations, participating in educational opportunities, reading professional publications, and maintaining professional networks in order to assist relevance in the current and future marketplace.
QUALIFICATIONS:
Bachelor's degree in accounting, business, health care administration, or applicable field.
Prior supervisory experience required.
Minimum one (1) year experience in pharmacy or medical billing required.
Strong analytical and problem-solving skills.
Must be proficient in data mining, and business software, including but not limited to Excel, Word and PowerPoint. Must be able to input and retrieve data from the facilities computer system.
Must have excellent verbal and written communication skills.
ADDITIONAL INFO:
Position is located east of Columbus.
Position reports to the Director whom is well respected and is with the facilities partner company.
Person should be able to manage a small billing team of 5-6 people so people and management skills are very important along with a high aptitude with Excel so reports and number can be pulled together for analytics.
The pay depends on experience but the range is between 69K-96K plus a full benefit package.
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