Description
Job Summary
This position plays a key role in implementing, monitoring, and enforcing University policy with the goal of minimizing risks associated with all aspects of billing as one method of preventing and detecting inappropriate, improper, and fraudulent conduct. In addition to managing a portfolio of compliance audits and investigations, the incumbent manages the workflow and performance of senior compliance and regulatory analysts, as well as coding and billing auditors. Additionally, this position requires the ability to function with autonomy demonstrating sound judgement and discretion.
Apply By Date
April 26, 2024 at 11:59pm PST; Interviews and recruiting process may occur at any time
Minimum Qualifications
Minimum License/Certification
- Must possess and maintain certification in professional or facility documentation, coding and billing, or both (i.e. CPC, CPC-H, or equivalent), or Change Management/Leadership certification (Lean Six Sigma, Fellow of the American College of Healthcare Executives (FACHE), etc.).
Minimum Education/Experience
- Bachelor's degree in Health Care, Business or Finance or equivalent experience/training.
- Extensive years of experience performing billing audits and/or quality control audits.
- Extensive years of leadership/management experience.
- Experience with and knowledge of instructional notations and conventions of ICD-9-CM, CPT, HCPCS classification systems; and ability to follow the detailed guidelines related to their use in assigning single, and sequencing multiple, diagnosis and procedure codes for appropriate reimbursements and data collection.
- Experience independently and effectively conducting revenue cycle investigations, including under attorney client privilege, if indicated.
- Experience in writing investigation reports, agreements, charge documents.
- Leadership, management and/or supervisory experience.
Minimum Knowledge, Skills, and Abilities
- Skills to interpret complex data and prepare comprehensive reports using complex analysis specific to the appropriate project.
- Proficient with medical terminology at a college level with the ability to understand disease processes, anatomy, and physiology necessary for assigning accurate numeric and alphanumeric codes.
- Knowledge of and experience with billing and claims processing to effectively carry out compliance monitoring and audit functions.
- Presentation skills to organize media methods for education and training to faculty, staff, and department and division administrators that may include the ability to communicate technical concepts in non-technical terms.
- Demonstrates excellent writing skills and experience in preparing reports, agreements, charge documents, corrective action, correspondence, proposals, policies and procedures, and other important employment documents. Ability to edit for correct grammar, spelling and punctuation.
- Knowledge of and ability to interpret federal and state laws, regulations, directives and other relevant resources to effectively apply requirements to billing, documentation, privacy and security requirements.
- Demonstrates skill and experience in analytical writing to produce accurate, useful reports and summaries.
- Ability to use discretion and maintain strict confidentiality.
- Extraordinary tact, diplomacy, discretion, professionalism, and judgment in the exercise of decision making and high-level communications.
- Outstanding speaking and listening skills.
- Ability to function as a member of an interactive team and to work independently as necessary.
- Ability to communicate facts, analyses, conclusions and recommendations in a clear, concise manner.
- Ability to effectively organize and manage multiple priorities in a fast-paced setting.
- Ability to work effectively with diverse populations at all levels of the organization, including faculty, senior administrators, legal representatives, Office of the President personnel, and external agency representatives.
- Demonstrates working knowledge of computer software to include Microsoft Word, Excel, Access, and PowerPoint, C360, Epic, MDaudit (or equivalent).
Preferred Qualifications
Preferred License/Certification
- One or more of the following such as CPC, CPC-H, CCS, CHC, CCS-P, COC, RHIT, or equivalent.
- Change Management Certification (LEAN, CCMP, or similar).
Preferred Education/Experience
- Master's Degree or higher in healthcare, finance or other relevant area. Juris Doctorate or other doctorate degree.
Preferred Knowledge, Skills, and Abilities
- Knowledge and ability to support the UCDH Code of Conduct, UCD Principles of Community, and contribute to the diversity of the campus through experience and/or ideas.
- Knowledge and ability to read and interpret university, UCDH, and UCOP policies.
- Ability to abides by AHIMA's established Code of Ethical principles to safeguard the public and contribute within the scope of the profession to quality and efficiency in health care, thus promoting ethical conduct.
- Knowledge of and ability to read and interpret University, UCD, and UCDH policies and procedures.
Department Description
The UCDH Compliance and Privacy Department is responsible for providing oversight for the UC Davis Health System's Compliance and Privacy programs. The department engages in a variety of activities to promote and ensure ethical and proper behavior in all matters related to UCDH business operations and to establish effective controls that promote adherence to applicable laws, regulations, rules, guidelines, requirements, procedures, and directives regarding Federal, State and Private health services. The UCDH Compliance and Privacy Department provides advice and assistance with compliance requirements and obligations of the UC Davis Health System to the Vice Chancellor-Health and Human Services and Dean- School of Medicine, Chief Executive Officer- UCD Medical Center, and other UC Davis Health System deans, executives and administrators.
Position Information
- Salary or Pay Range: $124,200 - $284,400 annually
- Salary Frequency: Monthly
- Salary Grade: 28
- Payroll Title: REGL AND CMPLNC HC MGR 1
- Number of Positions: 1
- Appointment Type: Career
- Percentage of Time: 100%
- Shift Hours: Mon – Fri
- Location: Sacramento, CA - Cannery Business Park (HSP110)
- Union Representation: N/A
- Benefits Eligible: Yes, full benefits
- Hybrid/Remote/On-Site: Locally based, hybrid
Benefits
Outstanding benefits and perks are among the many rewards of working for the University of California. UC Davis Health offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting our handy Benefits Summary and our Benefits Page
- High quality and low-cost medical plans to choose from to fit your family's needs
- UC pays for Dental and Vision insurance premiums for you and your family
- Extensive leave benefits including Pregnancy and Parental Leave, Family & Medical Leave
- 14 paid Holidays annually
- Paid Time Off begins at 24 days accrued per year
- Sick Leave
- Continuing Education (CE) allowance and Education Reimbursement Program
- Access to free professional development courses and learning opportunities for personal and professional growth
- Work Life and Wellness program and resources
- On-site Employee Assistance Program including access to free mental health services
- Supplemental insurance offered including additional life, short/long term disability, pet insurance and legal coverage
- Public Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified roles
- Retirement benefit options for eligible roles including Pension and other Retirement Saving Plans. More information on our retirement benefits can be found here
- UC Davis cares about building a community, which is why we provide resources to enhance diversity, equity and inclusion as well as Employee Resource Groups (ERGs) to support our staff
Special Requirements
This position is a critical position and subject to a background check. Employment is contingent upon successful completion of background investigation including criminal history and identity checks. As a condition of employment, you will be required to comply with the University of California Policy on Vaccination Programs, as may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.
Diversity, Equity, Inclusion and Belonging
At UC Davis, we're solving life's most urgent challenges to bring a fuller, healthier, and more resilient world within reach. We grow from every challenge we take on and we don't just maintain - we improve. We recognize that creating an inclusive and intellectually vibrant organization means understanding and valuing both our individual differences and our common ground. The most comprehensive solutions come from the most diverse minds, and you belong here.
As you consider joining UC Davis, please explore our Principles of Community, our Clinical Strategic Plan and strategic vision for research and education, and our latest efforts to outgrow the expected. The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.
Because we want you to be seen, our recruiting process at UC Davis fosters authenticity, diversity, and inclusion. Studies have shown that some people may not apply to jobs unless they meet every single qualification. Each unique role at UC Davis has a set of requirements and you could be perfect for this role, or you could be perfect for the next role! Don't meet all the requirements? We still encourage you to apply! #YouBelongHere
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