Supervisor, Health Insur & Auth

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

500183 Health Insurance Counseling

Work Shift:

UR - Day (United States of America)

Range:

UR URC 209 H

Compensation Range:

$25.09 - $35.12

Responsibilities:

Oversees team responsible for reviewing referrals for medical necessity and appropriateness of level of care. Assists patients with questions regarding referrals. May assist in obtaining authorizations for hospital services and ensure that the appropriate referrals are received prior to service. Supervises team and provides technical assistance.

ESSENTIAL FUNCTIONS

• Develops, maintains and teaches training program for new employees.
• Assesses staff's ongoing training needs, develops and implements training programs to address needs.
• Performs personnel administration, including recruitment, hiring, termination, performance evaluation, and performance improvement plans.
• Provides supervision, leadership, coaching and counseling. Serves as a role model and facilitator to staff.
• Ensures efficient and quality functions through high-cost reporting, work queues, and case review.
• Maintains departmental standards through quality assurance monitoring.
• Identifies problems or areas for system improvements and develops and implements resolution.
• Monitors customer satisfaction and acts on customer feedback to improve the quality of service.
• Analyzes volume and productivity and works in the staffing pattern as required to meet department standards.
• Collaborates with departments to integrate operations with other components of URMC, such as Financial Case Management, RIM, Utilization Management, Social Work, Patient Accounts, Medical Records, Finance, and Legal.
• Serves as a liaison to patients, physicians, nursing, social workers, other URMC staff, insurance companies. Serves on committees/teams as designated.
• Responsible for reviewing, validating, and maintaining accurate departmental procedures. Interprets hospital and administrative policies.
• Interprets third-party payer requirements and related regulations to ensure requirements are met through insurance bulletins and compliance reviews.
• Ensures Joint Commission Compliance.
• Collaborates with Manager to identify strategic goals and objectives.
• Develops and implements annual plan to accomplish goals.
• Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

• Bachelor's degree and 2 years of relevant experience required
• Or equivalent combination of education and experience

 

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.