Business Process Optimization Manager jobs in Rapid City, SD

Job Summary:

This position is responsible for providing management of the business office operations of the Oyate Health Center (OHC) including to establish, expand, and maintain fiscal capacity; develop and manage third-party billing reimbursement; and ensure quality control over processes spanning the functional areas that impact billing and revenue.

Essential Functions:

• Provides leadership and management oversight of all daily activities in the OHC Business Office related to budget, purchasing, personnel, administration, and performance management.
• Plans and directs billing, collections, and data processes to ensure accurate patient billing and efficient account collection.
• Reviews status of patient accounts to identify and resolve billing and processing problems.
• Hires, trains/precepts, assigns, schedules, directs, supervises, evaluates and disciplines assigned personnel.
• Assists in presenting budget reports and plans as necessary to governing officials.
• Updates the financial outlook throughout the year based upon quarterly spending and financial targets.
• Assist in developing, implementing, and administering annual capital budget.
• Participates in program planning and evaluation.
• Oversee development and management related to third-party billing reimbursement.
• Ensure quality control over processes spanning the functional areas that impact billing and revenue.
• Perform analysis and generate reporting for the purpose of helping to model revenue flow.
• Generate regular reports on revenue generation and forecasting.
• Ensure program is maximizing all funding streams to include new provider applications.
• Ensure enforcement of and compliance with all applicable internal and external policies, laws, and regulations.
• Maintains required records and files.
• Solves difficult payment and associated business office problems.
• Perform routine and random audits of accounts.
• Monitor the business office practices and ensure work is performed in accordance with applicable billing and reimbursement laws and regulations.
• Maintain policies and procedures for effective business office operations.
• Manage and maintain OHC’s business office software system and work cooperatively with IT to ensure timely and accurate implementation of necessary changes.
• Monitor for accuracy all ICD-10-CM/CPT/HCPCS codes for diagnoses and procedures.
• Maintains current knowledge of federal, state, and local regulations affecting areas of responsibility. Understands and complies with infection control, safety, and OSHA procedures and regulations.
• Maintain effective, collaborative interdepartmental and external relations.
• Must comply with federal laws and regulations as required by the Health Insurance Portability and Accountability Act (HIPAA).
• Performs related duties.

Professional Behavior

• Effectively plan, organize workload, and schedule time to meet the demands of the position.
• Work in a cooperative and professional manner with OHC and GPTLHB staff.
• Treat Great Plains tribes and collaborators with dignity and respect.
• Utilize effective verbal and written communication skills.
• Advance personal educational development by attending training sessions and seminars as appropriate.
• Exemplify excellent customer service with tribal stakeholders, health board colleagues, program partners, service recipients, visitors, and guests.
• Foster a work environment of wellness, courtesy, friendliness, helpfulness, and respect.
• Relate well and work collaboratively with coworkers and all levels of staff in a professional manner.
• Consistently demonstrate respect for and acceptance of differing capabilities, cultures, gender, age, sexual orientation, and/or personalities.
• Maintain and ensure organizational privacy and confidentiality.
• Handle crisis and tolerate stress professionally.
• Be self-directed and take proactive initiative to assist others.
• Resolve issues with other departments and coworkers without direct supervision if needed.
• Exercise flexibility to alter plans/routines when situations require and continue to perform without projecting stress/frustration that would adversely affect the work environment.
• Promote an alcohol, tobacco, and drug-free lifestyle.
• Embrace modes of appearance and attire that reflect a professional presence.
• Adhere to GPTLHB policies and procedures.
• Other duties as assigned by the Supervisor.

Requirements

• Participates in Core Connections training and applies GPTLHB Core Connections concepts and practices in their work.
• Knowledge of occupational health, safety, and environmental compliance program management principles.
• Knowledge of industrial hygiene, environmental and safety engineering, and fire protection.
• Knowledge of local, state, and federal occupational safety and health regulations.
• Knowledge of job hazard analysis and other analytical techniques.
• Knowledge of accident prevention principles.
• Knowledge of safety inspection principles.
• Knowledge of computers and job-related software programs.
• Skill in decision-making and problem solving.
• Skill in managing multiple projects.
• Skill in oral and written communication.
• Skill in prioritizing and planning.
• Skill in interpersonal relations.
• Skill in the use of such office equipment as a computer, scanner, fax machine, and copier.

Supervisory Controls

The supervisor sets the overall objectives and resources available. The employee and supervisor, in consultation, develop deadlines, projects, and work to be done.

The employee is considered an expert and is responsible for planning and carrying out the assignment, resolving most of the conflicts that arise, coordinating the work with others as necessary, and interpreting policy on their own initiative in terms of established objectives. In some assignments, the employee also determines the approach and methodology to be used. The employee keeps the supervisor informed of progress and potentially controversial matters.

Completed work is reviewed only from an overall standpoint in terms of feasibility, compatibility with other work, or effectiveness in meeting requirements or expected results.

Guidelines

Guidelines for performing the work are scarce or of limited use. Administrative policies, precedents, laws and regulations are applicable but are stated in general terms.

The employee uses initiative and resourcefulness in deviating from traditional methods or researching trends and patterns to develop new methods, criteria, or proposed new policies.

Complexity

The work typically includes varied duties that require many different and unrelated processes and methods, such as those relating to well established aspects of an administrative or professional field. Decisions regarding what needs to be done include the assessment of unusual circumstances, variations in approach, and incomplete or conflicting data.

The work requires making many decisions concerning such things as interpretation of considerable data, planning of the work, or refinement of the methods and techniques to be used.

Scope and Effect

The work involves treating a variety of conventional problems, questions, or situations in conformance with established criteria. The work product or service affects the design or operation of systems, programs, or equipment; the adequacy of such; the social, physical, and economic well-being of people; or the social or economic well-being of the organization.

Personal Contacts

The personal contacts are with individuals or groups from outside the organization in a moderately unstructured setting. For example, the contacts are not established on a routine basis and the purpose and extent of each contact are different.

Purpose of Contacts

The purpose is to influence, motivate, interrogate, or control persons or groups. The persons contacted may be fearful, skeptical, uncooperative, or dangerous. Therefore, the employee must be skillful in approaching the individual or group in order to obtain the desired effect, such as gaining compliance with established policies and regulations by persuasion or negotiation or gaining information by establishing rapport with a suspicious informant.

Physical Demands

The work requires some physical exertion, such as long periods of standing; walking over rough, uneven, or rocky surfaces; recurring bending, crouching, stooping, stretching, reaching, or similar activities; or recurring lifting of moderately heavy items. The work may require specific, but common, physical characteristics and abilities, such as above-average agility and dexterity. The employee must be able to read, write, speak, and hear.

Work Environment

The work involves moderate risks or discomforts that require special safety precautions, e.g., working around moving parts, carts, or machines; exposure to contagious diseases or irritant chemicals. Employees may be required to use protective clothing or gear, such as masks, gowns, coats, boots, goggles, gloves, or shields.

Supervisory and Management Responsibility

This position is a first level supervisor and is usually responsible for the work performance of a small group of employees or a larger group with a homogeneous objective (i.e., employees all perform the same basic type of work). The employee is responsible for planning, organizing, and monitoring day‑to‑day work on a short‑term cycle. This position assigns work to subordinates, adjusts workflow to maintain balance among positions and meet priorities or deadlines, and makes minor changes in structure, methods, or procedures as necessary to accommodate changes in work pattern, emphasis, or capability. The employee may recommend major changes for higher-level action. The employee usually counsels' employees, hears and resolves minor complaints and grievances, and participates in performance evaluation and personnel management recommendations.

Minimum Qualifications

Education/Relevant Experience: Bachelor’s degree and one (1) year of experience, or associate’s degree and three (3) years’ experience, or high school diploma or GED and five (5) years of progressively responsible experience.

This position requires post-secondary education and/or experience. Individuals must have applicable education and/or experience applying an extensive body of rules, procedures, or operations to perform a wide variety of interrelated or nonstandard procedural assignments and resolve a wide range of problems or to apply standard procedures in a technical field to perform such work as adapting equipment (requires consideration of the functioning characteristics of equipment), interpreting results of tests based on previous experience and observations (rather than directly reading instruments or other measures), or extracting information from various sources (requires considering the applicability of the information and the characteristics and quality of the sources).

The GPTLHB is a tribal organization which follows tribal preference laws. It is our policy to give preference to qualified Indian/Tribal candidates over qualified non-native candidates in hiring decisions, if all other qualifications are equal.

Employment is contingent upon the outcome of all required criminal background checks and pre-employment drug screen.