Overall responsibility to manage and supervise the operational and administrative functions, activities and projects for multiple Primary Care Offices. This position requires: effective leadership and supervision of all clinic staff, oversight of billing and collecting procedures, monitoring delivery of patient services, planning for space allocation, acting as a patient liaison with patients, specialists, hospitals and health plans. Adherence to regulatory requirements and efficient management of daily operations and supervision all clinic staff while maintaining medical cost ratios. The Administrator is responsible to ensure appropriate implementation of policies and procedures, promote member/patient satisfaction, sustain and facilitate enrollment growth. Works collaboratively with the lead physician to support physician productivity and quality care.
Duties and Responsibilities
• Manage the assigned regional clinic’s (POD= multiple clinic sites in a geographic region) operations to include but not limited to staffing, training, compliance, inventory, scheduling, medical records management, cost containment, community and health plan activities.
• Ensures compliance with Molina, State, Federal and local regulations and policies for health plan and clinic operations.
• Recruit, supervise, and direct all staff to ensure the clinic operates in an efficient manner and that the patients receive high quality customer service.
• Manage POD activities in collaboration with Physician Lead with emphasis on patient flow, and coordination of utilization of appropriate (or preferred, if applicable) specialty and hospital providers.
• Direct all billing and collecting procedures, to include appropriate coding and ensuring that staff are trained and educated in all government, national, and medical coding and billing regulations.
• Comply with required workplace safety standards.
• Review internal policies and procedures and recommend/write updates as indicated.
• Develop, implement and manage membership growth action plans which support established financial goals including budget, petty cash, timely submission of super bills, encounter reports and invoices. .
• Monitor delivery of patient services to include reviewing physician activity data and forecast and prepare for all changes needed or impacted by patient load, billing/collecting procedures, and government regulations and policies.
• Complete various special projects, which may require reviewing and analyzing information, identifying problems, recommending solutions and writing reports.
• Manage clinic participation in studies, surveys, audits, space planning, renovation and special projects as required.
• Manage patient and member grievances for the clinics in appropriate collaboration with the MMG Operations team and Member Services Department.
• Function as the clinic liaison with patients, specialists, hospitals and health plans.
• Other duties as assigned
Knowledge, Skills and Abilities
• Have knowledge of budgets and budget process including mathematical and accounting skills, ability to make sound financial decisions, and ability to use calculator.
• Knowledge of CPT/ICD- 9 coding procedures and be familiar with Medicaid, Medicare, and State Program insurance billing procedures.
• Ability to proceed on own initiative using independent judgment and discretion.
• Possess excellent verbal and written communication skills, leadership and organizational skills, and interpersonal and time management skills.
• Have ability to document and perform critical review of policies and procedures.
• Knowledge of computer technology, including word processing, spreadsheet, database, and graphics software in order to prepare publications, reports, and business correspondence.
• Have knowledge of office management and administrative procedures, and the ability to supervise and review the work of others.
• Possess knowledge of specialized terminology including medical, legal, and/or construction.
• Ability to interact with Providers, Medical Staff, professional, administrative and higher level management personnel.
• Familiarity with medical records administration, and knowledge of clinic and physician/provider to patient protocols.
• Ability to abide by Molina’s policies and procedures.
• Maintain regular attendance based on agreed-upon schedule
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
• Bachelor’s Degree in Administration or Health related field, or equivalent experience.
• 5 years supervisory experience in healthcare
• 5 years healthcare experience
• 3+ years experience in managed healthcare
To all current Molina employees if you are interested in applying for this position please fill out an Employee Transfer Request Form (ETR) and attach it to your profile when applying online. Be sure to let us know you are a current employee by selecting “Molina Employee (current) in the source section of the online application.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare - 23 months ago
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