Health Underwriting Manager jobs in Bakersfield, CA

Job Summary:    The person in this position is part of the team concept in the Patient Center Health Home which is devoted to the delivery of primary care in an ambulatory setting, with an emphasis on prevention and health maintenance. The person in this position reports to the District Health Services Administrator and works closely with the Director of Nursing, providers, nurses, and support staff to assure effective patient and client service objectives in the health centers. The Health Center Manager will oversee the day to day operation of the Front Office and Back Office Staff, ensuring that staff continues performing their duties and carrying on the necessary functions required in accordance with established policies and procedures. The Health Center Manager is responsible for the compliance with federal, state and local requirements pertaining to health center issues.

Job Duties:

1.    Observe front office efficiency

•    Make sure that patients are processed within reasonable time.

•    Guarantee excellent customer service to all patients of Omni Family Health.

•    Review and make certain that registration is completed properly and in accordance to established protocols.

•    Review and make certain that co-pay/ balance/ deposits/ share of costs are collected from each patient.

•    Review and make certain that cash register is balanced daily – receipts are issued properly.

•    Make sure telephone calls are answered within three rings.

•    Ensure staff are trained in NextGen, i2i, and data programs in relation to front office duties. Make certain all data is properly captured in NextGen or applicable Practice

•    Management System.

•    Make sure verification and collection of demographics is captured by front office at each patient visit.

•    Guarantee proper insurance verification, work closely with insurance plans, and direct patients to appropriate assistance programs.

•    Properly collect UDS patient information.

•    Monitor the no- show patients and complete the no- show process.

•    Prepare health center for all private, county, state, and federal audits. .

•    Generate, review, and analyze all reports pertaining to the operations of the health center.

2.    Observe back office efficiency

•    Make sure that patients are called back within a reasonable time.

3.    Assess and create goals towards the improvement of the health center.

4.    Report any building physical damage and equipment condition to the General Services Supervisor within 24 hours. Review ancillary services and specialty services:

•    Make sure services are available and provided on a consistent basis.

•    Make sure specialty providers have adequate personnel support.

•    Communicate any chart issues to Nursing staff, District Health Services Administrator and or provider.

5.    Review patient schedules.

•    Make sure that providers are aware of their patient schedule for the day.

6.    Discuss with provider about triage, patient flow, and patient concerns/complaints.

•    Review walk-in status and communicate to provider whether or not triage is needed to avoid back log.

7.    Act as Liaison between staff and District Health Services Administrators, Director of Nursing and Health Center Nurses regarding staff development and satisfaction.

8.    Coordinate involvement of staff in all OFH activities (e.g. Health Fair, Outreach programs, and company functions).

9.    Demonstrate knowledge of safety and OSHA practices.

10.    Follow universal precautions to protect self and patients,

11.    Collect, assess, and report data for Quality Improvement reports.

12.    Make certain MA stock room is supplied as necessary.

13.    Train staff and extern students about OFH policies, procedures, and protocols.

14.    Prepare health centers for any and all site inspections, audits, and health center visits.

15.    Any other duties or responsibilities required by operations staff may be assigned from time to time and when the need arises.

Administrative Duties:

1.    Order and submit all necessary supplies with purchasing department according to established protocols and procedures.

2.    Prepare monthly staff meeting agenda and minutes.

3.    Review QI reports and perform QI checklist.

4.    Directly responsible for all front office personnel.

5.    Communicate with Call Center personnel any provider scheduling conflicts or improvements.

6.    Communicate health center operation and QI results with support staff and direct concerns to District Health Services Administrator. /

7.    Communicate any and all route slips corrections/completion or problems with Billing department.

8.    Submit Monthly report to Operations Management Associate.

9.    Assist providers in closing encounters.

10.    Prepare staff schedules for front office.

11.    Approve/Deny staff request for time off with pay/without pay.

12.    Uphold and maintain HIPAA compliance.

13.    Serve as experts in all patient assistance programs.

14.    Execute all new or revised policies and procedures.

15.    Address patient complaints, prepare incident reports, prepare unusual occurrence reports, and any matter requiring attention in the health center.

16.    Stock and order supplies for the health center.

17.    Employee coaching, counseling, and disciplinary action.

18.    Serve as a member of Omni Family Health Leadership committee and attend all pertinent operations meetings.

Job Requirements:

1.    Ability to work under pressure.

2.    Ability and willingness to treat all patients with the utmost kindness and consideration in the most trying situations.

3.    Friendly personality with the desire to work with the public.

4.    Ability to handle multi-functions.

5.    Understanding of community based organizations.

6.    Promotes and believes in OFH mission statement.

7.    Ability to relate to the public regardless of ethnic, religious and economic status.

8.    Must be willing to work at any Omni Family Health location other than the assigned site and be agreeable to work weekends, if so needed.

9.    Must obtain a Valid California Drivers License at all times plus proof of insurance, to allow you to be placed in all Omni Family Health centers if needed.

10.    Commitment to the concepts of preventive health care program and team approach to health care delivery.

Additional Duties:

1.    HIPAA compliance - Responsible for maintaining abreast of and in compliance with all

H.I.P.A.A. regulations and requirements. Treats all member information confidential.

2.    Compliance - Ensure compliance with all local, state and federal regulations.

3.    QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.

4.    IT - Required to learn and use the EHR/EOHR (Medical Practice Electronic System) and its components, as required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, Healthport, PMS, QSI and other electronic features developed and implemented, as applicable to work environment.

5.    All employees will participate in Patient Centered Health Home Model at Omni Family Health.

Qualifications, Education, and Experience:

1.    Must have High school diploma or equivalent and have successfully completed and graduated from a medical assistant program with a minimum of three years of experience as a medical assistant or must have graduated from an accredited university with a Bachelor’s Degree in Public Administration, Healthcare Administration, or equivalent. Education and Medical Management experience in lieu of the above.

Level I

Work requires 3 year of related administrative or health center/practice management experience to acquire competence in applying general operational practices, personnel practices, accounting and budgeting principles and coordination of health center administrative functions.

Level II

Work requires 5 years related administrative or health center management experience to acquire competence in applying general operational practices, personnel practices, accounting and budgeting principles and coordination of health center administrative functions.

Level III

Work requires 5 years related administrative or health center management experience to acquire competence in applying general operational practices, personnel practices, accounting and budgeting principles and coordination of health center administrative functions.

2.    Venipuncture Certificate or equivalent preferred.

3.    Bilingual in English/Spanish may be required.

4.    Must have leadership abilities and demonstrate management skills.

5.    CPR Certificate preferred

Responsible To:    District Health Services Administrator

Classification:    Full Time Position, Exempt