Corporate Responsibility Manager

  • Adventist Health System
  • Altamonte Springs, FL, USA
  • Jan 20, 2018
Healthcare

Job Description

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for a Corporate Responsibility Manager position that will be based in our Corporate Responsibility department. This position is based at our corporate office in Altamonte Springs, FL.

This position provides the opportunity review the data, analysis, monitoring and auditing functions for Corporate Responsibility. Responsibilities will include reviewing and analyzing various compliance data, including performing data extractions and manipulating the data, and reporting the results of the data review and analysis; auditing and interpreting the results of the monitoring and auditing plan provided by the Corporate Responsibility Department by each of the AHS regions; coordinating external audits; and managing the compliance hotline.

Specific job duties include:
  • Reviews and analyzes various compliance data, including performing data extraction and manipulation.
  • Requests additional information as needed and keeps track of outstanding requests.
  • Identifies concerns arising from the data and identifies potential resolutions and reports to appropriate leadership.
  • Downloads and manipulates Medicare MEDPAR data for database.
  • Performs data analysis using hospital HPM data, such as one day stays and readmission rates.
  • Analyzes DRG/APC volumes (including DRG dyads) using the MEDPAR data and hospital HPM data
  • Reviews M&A activities on a real time basis for thoroughness and adequacy of information provided.
  • Audits and interprets M&A results for critical analysis of the audit and escalates for review as appropriate.
  • Rejects results containing insufficient or incomplete items and notifies appropriate individuals to obtain sufficient data.
  • Presents results of the M&A audit and analysis of the results to supervisor.
  • Assumes responsibility for coordinating external physician and hospital audits.
  • Reviews results of audits and identifies trends, coding issues and other concerns.
  • Reports trends and issues to supervisor.
  • Assigns new calls to the appropriate Regional Corporate Responsibility Officer.
  • Prepares annual reports on the calls and identifies trends and concerns.
  • Prepares the employee, physician and vendor data for upload in the Excluded Party Search System (EPSS) and makes certain the data is in the correct database format.
  • Maintains and updates the Corporate Responsibility policies on a regular basis.
  • Manages special projects and other projects as assigned to meet deadline and standard of production.
  • Responds to and provides research on various compliance related questions from AHS facilities.
  • Assists with complaints and facilitates a resolution or appropriate routing.
  • Provides monthly orientation presentation to new hires on Compliance (Compass Point).

Experience Requirements:
  • Minimum of five years in healthcare finance or auditing experience required


Educational Requirements:
  • Bachelor's degree required
  • Master's degree preferred


Software:
  • Proficiency in Microsoft Office Suite required HPM experience preferred


If this position sounds like a great match for your skills set and experience, please apply online now!

Reference

257086