101401 - Dir-Clinical Denial Recovery

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Business (Non-Clinical)
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2011266 Requisition #
GENERAL SUMMARY: The Director of Clinical Denial Recovery Unit (CDRU) is responsible for developing and leading a centralized denial recovery operation. The director will lead planning and execution of strategic initiatives around medical necessity denials, payer relations, and hospital site collaboration. This position is responsible for the development and execution of a comprehensive Denials Management program which ensures timely and efficient follow up on payer denials. In addition, this position is responsible for driving strategic initiatives related to payer relations and escalations. This position will work closely with clinical, operational, utilization management, managed care, legal, and financial stakeholders to ensure the health system has a centralized comprehensive approach to denial management and mitigation. EDUCATION/EXPERIENCE REQUIRED: Bachelor's degree required, preferably in business, healthcare or another related field. Master's degree in business or other health administration related field preferred. Minimum of five (5) years leadership experience working in Managed Care, Utilization Management, Finance, or Revenue Cycle in a large, complex, integrated healthcare organization, with director level preferred. Extensive experience with government reimbursement programs and payment methodologies. Demonstrated fluency in healthcare financial management and revenue cycle management best practices. Strong detail orientation and project management skills. Excellent communicator - able to express complex ideas clearly and effectively to a varied audience. Ability to manage, coordinate, and lead simultaneously. Ability to estimate time frames and meet projected deadlines. Able to develop buy-in and drive change across a wide variety of team members, departments, and stakeholders, including physician and senior-level leadership. Must demonstrate a history of reliability, consistent process management, productivity management, and strict maintenance of appeal inventories.

EDUCATION/EXPERIENCE REQUIRED: Bachelor's degree required, preferably in business, healthcare or another related field. Master's degree in business or other health administration related field preferred. Minimum of five (5) years leadership experience working in Managed Care, Utilization Management, Finance, or Revenue Cycle in a large, complex, integrated healthcare organization, with director level preferred. Extensive experience with government reimbursement programs and payment methodologies. Demonstrated fluency in healthcare financial management and revenue cycle management best practices. Strong detail orientation and project management skills. Excellent communicator - able to express complex ideas clearly and effectively to a varied audience. Ability to manage, coordinate, and lead simultaneously. Ability to estimate time frames and meet projected deadlines. Able to develop buy-in and drive change across a wide variety of team members, departments, and stakeholders, including physician and senior-level leadership. Must demonstrate a history of reliability, consistent process management, productivity management, and strict maintenance of appeal inventories.

    Overview

       Under the leadership of President and CEO Wright L. Lassiter, III, Henry Ford Health System is a

       $6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites

       including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and

       other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system

       now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one

       of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the

       health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s  

       major academic medical centers, receiving between $90-$100 million in annual research funding and

       remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical

       education and training, the health system has trained nearly 40% of physicians currently practicing

       in the state and also provides education and training for other health professionals including nurses,

       pharmacists, radiology and respiratory technicians. visit HenryFord.com.

     Benefits

       Whether it's offering a new medical option, helping you make healthier lifestyle choices or

       making the employee enrollment selection experience easier, it's all about choice.  Henry

       Ford Health System has a new approach for its employee benefits program - My Choice

       Rewards.  My Choice Rewards is a program as diverse as the people it serves.  There are

       dozens of options for all of our employees including compensation, benefits, work/life balance

       and learning - options that enhance your career and add value to your personal life.  As an

       employee you are provided access to Retirement Programs, an Employee Assistance Program

       (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness,                 and a whole host of other benefits and services.  Employee's classified as contingent status are not         eligible for benefits.    

      Equal Employment Opportunity/Affirmative Action Employer

        Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

        committed to the hiring, advancement and fair treatment of all individuals without regard to

        race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

        weight, marital status, family status, gender identity, sexual orientation, and genetic information,

        or any other protected status in accordance with applicable federal and state laws.

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