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Manager, Message InBasket Support, Pharmacy

Sutter Health

Los Altos, CA

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JOB DETAILS
SALARY
$107,785.60–$161,678.40 Per Year
SKILLS
CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing), Call Volume, Centers for Medicare and Medicaid Services (CMS), Computer Science, Current Procedural Terminology (CPT), Customer Support/Service, Documentation, Establish Priorities, Federal Laws and Regulations, Finance, Financial Administration, Government Billing, Government Regulations, HIPAA (Health Insurance Portability and Accountability Act), Healthcare Administration, Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD), Interpersonal Skills, Medi-Cal, Medicaid, Medical Terminology, Medicare, Metrics, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Multitasking, Patient Assessment, Patient Follow-up, Pharmacy, Service Delivery, State Laws and Regulations, Time Management
LOCATION
Los Altos, CA
POSTED
Today
We are so glad you are interested in joining Sutter Health!


Organization:


PAMF-Palo Alto Medical Foundation CAD


Position Overview:


Accountable for ensuring accurate and timely completion of all referrals and authorizations and acts as a resource to providers, clinical operations, and staff. Maintains department metrics and ensures that established turnaround times are adhered to. Works daily to evaluate referral volume, patient call volumes and distributes workload accordingly. Responsible for creating and maintaining workflows and documentation for the following: verifying patient eligibility, coordination of benefits, ensuring accurate insurance coverage, and determining if prior authorization is needed for physician orders. Investigates and responds to patient and provider escalations regarding inquiries and referrals not meeting turnaround standards.


Job Description :


EDUCATION:

_Equivalent experience will be accepted in lieu of the required degree or diploma._


Bachelor's: Business, Finance, Computer Science or related field


TYPICAL EXPERIENCE:


+ 8 years recent relevant experience

+ Pharmacy experience strongly preferred


SKILLS AND KNOWLEDGE:


+ Knowledge of insurances and authorization processes.

+ Familiarity with government billing regulations, including The Health Care Finance Administration (HCFA), Medicare, and Medi-Cal/Medicaid.

+ Medical Terminology, familiarity of state and federal laws regarding Health Insurance Portability and Accountability Act (HIPAA).

+ Knowledge of Microsoft Office Suite, including but not limited to Excel, Word and Power Point proficiency.

+ Ability to effectively utilize consultative skills and maintain interpersonal relationships with the department and at all levels of the organization.

+ Well-developed phone and customer service skills including the ability to professionally, calmly, and effectively work with all customers, including the ability to de-escalate patient and/or provider escalations.

+ Organizational and time management skills, with the ability to prioritize multiple projects while delivering quality service and achieving business results.

+ Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge.


Job Shift:


Days


Schedule:


Full Time


Days of the Week:


Monday - Friday


Weekend Requirements:


As Needed


Benefits:


Yes


Unions:


No


Position Status:


Exempt


Weekly Hours:


40


Employee Status:


Regular


Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.


Pay Range is $107,785.60 to $161,678.40 / annual salary


_The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package._

About the Company

S

Sutter Health

Sutter Health has a long history in California. Some of our facilities have been providing care in the communities we serve for more than 100 years. Today, we’re proud to partner with more than 12,000 doctors to care for more than 3 million people.

We’re inspired by our Northern California community and work tirelessly to deliver top-rated, affordable healthcare. Doctors, hospitals, care teams and employees in the Sutter Health network are always looking for new, meaningful ways to care for you and your loved ones. We believe that every moment matters when it comes to helping you live a longer, healthier and happier life.

Our not-for-profit network delivers top-rated, personalized care in more than 100 Northern California communities. Recently ranked among the Top 15 Health Systems in the nation by Truven Health Analytics™, our team of more than 50,000 doctors, employees and volunteers partner to spread innovation, improve access to healthcare services and put our patients’ needs first—all to achieve the highest levels of quality, access and affordability.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
EMPLOYEE BENEFITS
Professional Development, 401K, Flexible Spending Accounts, Retirement / Pension Plans, Tuition Reimbursement, Life Insurance
FOUNDED
1921
WEBSITE
https://jobs.sutterhealth.org/

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