Job Description

At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

Responsible for the authorizations and admissions program. The Mgr, Admissions oversees the referral, and intake processes and maintains communication with the sales and operations teams. Responsible allocating the work of the admissions and authorizations teams and ensuring the compliance and regulatory standards at each of their assigned hospitals. Works closely with the Sales team to create and maintain efficient and effective processes. Responsible for meeting and maintaining performance targets set forth by the organization.

Essential Functions 

• Leads the local operations of the admissions office, including supervision of the Clinically Appropriate Management Specialists, Admissions Coordinators, and Admissions Specialists. 
• Review key performance measures in authorizations and admissions and prepare recommendations to improve overall performance.
• Serve as a liaison with local sales, marketing, business office, managed care, and administration of the facilities to ensure timely processing of admissions and to ensure total customer satisfaction.
• Support coordination of admissions with other departments by facilitating the collection and distribution of appropriate information
• Train and orient new admissions staff and assist with cross-training of staff for authorizations and admissions backup purposes.
• Serve as a resource for staff who may experience difficulties with various referral sources or payor organizations; provide specific interventions if necessary.
• Maintain state-of-the-art knowledge of areas of responsibility and follows a program of continuing education.
• Ensure all concurrent denials are reviewed for appropriateness and appealed when patient meets LTAC continued stay criteria. Escalate to medical staff for Peer-to-Peer if needed.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.

Knowledge/Skills/Abilities/Expectations

• Direct experience in third-party reimbursement and knowledge of how benefits under various insurance programs are applied in the post-acute care setting
• Strong relationship building skills and a spirit to serve and ensure effective communication and service excellence 
• Strong knowledge of regulatory standards and compliance guidelines
• Critical thinking, problem solving, and decision-making capabilities 
• Computer skills that include Microsoft Office Suite including, but not limited to: Word, Excel, PowerPoint, and Outlook
• Must read, write and speak fluent English.
• Must have good and regular attendance.
• Approximate percent of time required to travel: 0%
• Performs other related duties as assigned.
• Ensure the team has safeguards in place to protect the assets of Scion Health from initial verification/authorization to continued stay eligibility and authorization protocols.
• Analyze team members processes and actions to ensure that all activities are value add to the quality of patients stay and financial wellbeing of Scion Health.

Education

• Bachelor’s Degree Required
• Masters Degree Preferred (clinical area preferred) or equivalent experience

Experience

• Minimum of three (3) years of experience in case management, admissions office management or similar leadership capacity
• Proven history of effective relationship management in a matrix reporting structure is preferred.
• Some travel may be required, but minimal.

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