15271 Laguna Canyon Rd, Irvine, California, 92618, United States of America
This position has two primary responsibilities.
First is to provide timely processing of American Kidney Fund (AKF) premium assistance requests to ensure patients who are eligible, retain insurance coverage. In addition, assist the Drug Replacement team with research for uninsured patients for potential product replacement.
Second is to supervise 3 - 6 teammates responsible for patient assistance within their state footprint. The focus of the collective team is to process American Kidney Fund (AKF) and Drug Replacement (DR) documents timely and accurately.
SUPERVISORY RESPONSIBILITIES: Yes
Position has supervisory responsibility for hiring, retention, performance development, performance management, teammate relations, salary adjustments, and termination of direct reports.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.
Provide day-to-day supervision to Patient Assistance team
Perform quality improvement audits of Drug Replacement (DR) submissions
Complete Drug Replacement Vendor forms as needed
Log, research, and post payments and returned checks; provide reports as necessary in absence of Database Specialist
Review AKF and DR reports to ensure timely insurance premium payments and drug replacement
Maintain and ensure confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
Provide training to social workers formally and ad hoc
Perform other duties and responsibilities as assigned including but not limited to:
Attend and/or lead team meetings, phone conferences, and training as needed
Act as a liaison between facility teammates and AKF to resolve patient insurance issues and/or concerns
Maintain relationship Vendor partners
Identify, resolve or escalate issues (processing) as appropriate for prompt and effective resolution
Travel requirements: 5%
AKF Request Processing
Evaluate eligibility of financial assistance requests; research and assist Social Workers with problematic requests
Communicates status and outcome to Social Worker
Record requests in database for tracking; ensure timely processing for prompt turnaround time of urgent requests to ensure financial assistance needs are submitted for patient insurance continuation
Generate grant requests in AKF's web-based system; ensure accuracy to avoid returned requests
Research returned requests and/or premium checks; correct and/or obtain needed information for reprocessing
Review, update and submit department reports; follow up on unpaid premium requests, missing premium requests, and missing HIPAA authorization forms
File and purge records as needed
Provide high-level customer service to social workers to ensure AKF HIPP requests are processed timely and accurately
Establish and build relationships with clinical resources and Vendor partners to emphasize and integrate Patient Assistance priorities
Review weekly reports to identify potential patient insurance issues
Assist in updating related Policy and Procedures
Create and provide training to clinical teammates as needed
Provide monthly reporting and analysis on key metrics related to AKF and Drug Replacement to management
Compile quarterly operations reviews on assigned portfolio
Monitor and evaluate weekly and monthly key metrics to identify trends or areas of focus
Provide leadership to direct reports and department
Partner with manager on all teammate employment activity such as hiring, promoting, job performance, evaluations, compensation, disciplinary actions, and termination effectively and professionally
Ensure accurate, timely processing of changes in the Workday system
Provide work direction for department teammates
Address teammate relations issues appropriately; escalate as necessary
Know, understand, implement, follow, and communicate to teammates all DaVita employment policies and procedures, awards, and other opportunities within company; develop and foster a positive, fulfilling work environment; enable teammates to excel in their assigned roles
Review and approve time cards of hourly direct reports for bi-weekly payroll
Track overtime, attendance, and PTO
Facilitate teammate development (PDRs, coaching, mentoring, DaVita training, outside training); collaborate with direct reports to create professional development goals
Provide work direction for department teammates including goals and goal achievement measurements
Determine staffing plans that promote the most effective use of all teammates; ensure coverage during teammate absences
Develop and conduct educational programs to keep teammates up-to-date on DaVita policies, new laws and regulations impacting work, and other information necessary to maintain teammates' knowledge of department processes and goals
Other duties and responsibilities as assigned
Attend team meetings, phone conferences, and training as needed
Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
Participate as requested in special projects and team initiatives
Mentor team members as appropriate on Patient Assistance practices
Meet with new teammates after training to obtain feedback
(Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required)
High school diploma or equivalent required
Bachelor's degree preferred
Minimum of two (2) years' experience in customer service, healthcare organization and/or insurance company
Demonstrative extensive understanding of insurance plans and benefits (PPO, HMO, POS, EPO, Indemnity) required
Demonstrative understanding of COBRA and Coordination of Benefits strongly preferred
Intermediate computer skills in MS Word, Excel, SQL Server, Access, PowerPoint, and Outlook required
Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."
Why wait? Explore a career with DaVita today.
Go to http://careers.davita.com to learn more or apply.
What We'll Provide:
More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.
Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.
At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed Diversity & Belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and an affirmative action employer. As such, individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.
Salary/ Wage Range
Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience and may fall outside of the range shown. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits
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