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Manager of Customer Engagement - Referrals and Authorizations

Renown Health
United States, Nevada, Reno
1155 Mill Street (Show on map)
Feb 27, 2025
100631 Engagement Center Admin
Reno , NV
Full Time - Eligible for Benefits
Management
Day
Posted 02/24/2025
M-F 8:00am to 5:00pm
Req # 181490
Biweekly Hours: 80

Position Purpose







With the support of the Director of Customer Engagement, this position is accountable for the quality performance of the Engagement Center for Renown and Hometown Health by aligning operations with the organization's mission, vision, and values. This person must have a passion for quality and be a strong collaborator to provide centralized services for clinics, the health plan, and hospital at the highest possible standards of excellence for patients and physicians. This position completes this wonderful work remotely and in the office.









Nature and Scope







This position is responsible for operational aspects of the department, in addition to supervising the team members, this position performs the following:

* Use independent judgment to administer all aspects of related personnel policies.

* Plan, direct, and manage the business operations including developing new support service lines and programs. This may also include the oversight of additional functions such as project planning, facilitating meetings, implementation, and change management.

* Must be able to manage to key performance indicators and metrics associated with call center staff and personnel which may include driving service levels, quality outcomes & service, managing production, and staffing appropriately to proactively meet customer service needs. Manages turnaround time on referrals turnaround times.

* Plans, directs and manages major implementations of new equipment, software, and processes.

* Manages effective marketing campaigns & develop relationships with Renown & community referring physician offices for all Engagement Center business.

* Perform continual process improvement using lean methodology. Increase automation and streamline processes to improve customer service satisfaction while increasing efficiencies and managing costs.

* Supervises and/or prepares reports, documents, payroll records, statistical surveys and other data required for departmental administration and for compliance with various licensing and regulatory agencies. Analyze data and create necessary reporting to manage and improve the business.

* Prepares departmental, operational, and capital equipment budgets; is responsible for managing and explaining actual budget fluctuations.

* Is directly involved in short and long range department planning and communication of strategy as well as aligning their teams' work to the mission and vision of the organization.

* This position is responsible for employee retention, compensation, engagement, and career development.

* This position is to plan, develop and implement department procedures; hire, evaluate, coach and terminate employees.

* This position is responsible for understanding CMS STAR measures & to implement processes, programs and manage performance to support the achievement of these measures.

This position is responsible for developing, improving and maintaining a compliance program that ensures compliance with state and federal regulations, including, but not limited to HIPAA, the Centers for Medicare and Medicaid Services (CMS) and the state of Nevada Division of Insurance.

* This position must be able to communicate with patients, the general public, senior leadership, employees and clinicians.

The Engagement Center is experiencing considerable change requiring the incumbent to keep abreast of the state-of-the-art in technology and best practices. As a manager, the incumbent must be an effective communicator and have the capacity to effectively problem-solve, make appropriate decisions, and produce desired results.

KNOWLEDGE, SKILLS & ABILITIES

* Strong customer service skills with the ability to provide service recovery immediately as needed.

* Working knowledge CMS regulations as they relate to a Medicare Advantage Plan.

* Working knowledge of health insurance.

* Working knowledge of medical billing practices to include, but not limited to medical terminology, CPT, ICD9/10, and HCPCS coding.

* Ability to communicate diplomatically, clearly and concisely, both verbally and in writing.

* Ability to maintain confidentiality of medical and personal information of all customers.

* Ability to ensure all goals and deadlines are met.

* Ability to develop and provide education programs to maintain a competent and efficient staff.

* Ability to analyze and interpret data, control deficiencies and initiate corrective action as needed.

* Demonstrated skills in problem identification, problem solving and process improvement.

* Demonstrated leadership skills to promote individual and team excellence.

* Strong organizational skills.

This position does not provide direct patient care.









Disclaimer





The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.









Minimum Qualifications

Requirements - Required and/or Preferred







Name



Description



Education:



Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelor's degree preferred.



Experience:



Experience in Contact Center, Healthcare preferred. 2 years experience in leadership.



License(s):



None



Certification(s):



Project Management & Lean Six Sigma is preferred.



Computer / Typing:



Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Experience with call center technology and Epic.







Actual salary offered may vary based on multiple factors, including but not limited to, an individual's location and their knowledge, skills, and experience as well as internal equity.
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