Sr. Manager, Financial Counseling

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The Department of Stem Cell Administration is currently seeking a full time Sr. Manager, Financial Counseling to work in Miami. The Senior Manager, Financial Counseling coordinates financial and clinical provider teams and services. This role procures, designs, negotiates, and executes financial decision support projects with the clinical and administrative staff. The incumbent supervises a team of SCT Finance Case Managers while supporting the following areas : Budgeting, Cost Analysis, Proper Expected Transplant Reimbursements, Staffing Productivity Management, and Financial Planning. He / she will function as the team leader for start-up activities and new programs initiated by the Adult Transplantation and Cellular Therapy Program and the hospital. Responsibilities require close interaction with physicians and department directors / managers, nurse coordinators and ARNP's regarding interpretation and distribution of clinical and transplant related financial data.

Core Responsibilities :

• Manages and determines the liability on patient accounts and works with patients or their representatives to provide financial planning, accurate relevant information and or secure payments for the Adult Stem Cell Transplant Program.
• Oversees the operations of the Stem Cell Transplant Finance department. Ensure that the Workqueue's that hold high dollar transplant patient accounts are worked in UChart to make billing edits for a clean claim transplant to be submitted to the insurance for the recipient and the donor. This includes all transplant types, allogeneic unrelated and related, autologous and CAR-T.
• Work closely with Central Business Office (CBO) / Transplant Hospital Billing team regarding insurance case rates, case edit creations in UChart and all other transplant billing related matters.
• Manages, develops, and maintains decision support system to ensure availability of accurate and timely revenue, cost, and utilization of data used by all levels of management within the organization.
• Interacts, communicates, and intervenes with multidisciplinary healthcare team in a purposeful, goal-directed manner. Works proactively to maximize the effectiveness of resource utilization. Anticipates, initiates, and facilitates problem resolution around issues of resource use and continued hospitalization and discharge planning.
• Works with all levels of the institution in the strategic decision-making process while maintaining the required degree of confidentiality and professionalism.
• Maintains accuracy and data integrity in the decision support system through audits and routine reviews of data.
• Works with Revenue Integrity to create Stem Cell Transplant specific policies and procedures, build revenue capture models, track revenue inconsistencies within hospital departments and work with IT / Sr. Systems Engineer to resolve any issues in a timely manner.
• Implements and maintains resource utilization systems across all hospital departments. Maintains regular communication with department managers regarding required insurance authorizations and financial clearances. Access the Department Appointment Report (DAR) in UChart to financially clear appointments for transplant recipients and donors.
• Maintains a proactive role to ensure appropriate documentation concurrently to minimize inefficient resource utilization and prevent loss of reimbursement.
• Utilizes financial and decision support systems to perform complex financial evaluations of new processes, including assessment and confirmation of SCT Volumes, reimbursement, payor mix, operating costs, expected transplant reimbursements and the financial structure in accordance with departmental policies and procedures.
• Prepares and / or validates assumptions, complex calculations, schedules and other documentation in developing the Specialty Hospitals annual capital and operating budgets with assistance from the Transplant Administrator.
• Communicates with departments to resolve various budget-related financial problems and procedures. Assists directors / managers in understanding variances from budget and documents new issues that impact the current and future budget developments with assistance from the Transplant Administrator.
• Ensures internal control oversight and compliance with laws and regulations, contracting, safeguarding of assets, compliance with University policies and procedures, reliability of internal and external reporting, researches each transplant by Hospital Account Record (HAR) Chart for efficiency and effectiveness of proper transplant reimbursements / operations. Creates an effective control environment, conducts risk assessment, implements and monitors controls.

Core Qualifications :

Education : Associate degree required. Bachelor's degree in relevant field; relevant years of experience will be considered.

Experience : Minimum 5 years of relevant experience.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Females / Minorities / Protected Veterans / Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.